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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NF' <br /> SALEM, OREGON 973(}1 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PRONE: 588-7904 <br />'a~ performi.gw0rkonaPropert¥1own o~0oc. PY, <br /> <br /> 'iLE <br /> <br />BRUCE PACKING CONPANY (BRUCE PACK) <br /> <br /> 1~;~,.64 S,[LVER FALLS HI~Y -- <br />AUHPVILLE OR ~)732.~ HARION COUNTY: NO <br /> <br />r~ILiNG A~ORES$: <br /> <br />SANE <br /> <br />OCCUPANT LOAD; <br /> 70 <br /> <br /> i NO OF B~PROOMS: <br /> <br /> MEAl:PROCESSING ,PLAN't , <br /> <br /> SiTE NUMBER: <br /> VALUATION: <br /> <br /> f~WN~IP; RANGEi ~ONE; <br /> <br />22 <br /> 8S <br /> <br /> MAP: <br /> <br /> 47 <br /> <br />NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATIOH HO: 9847710 <br /> <br />6ON'fRACTOR. NO. 3694? <br /> AAA SEPTIC SERVICE <br />PO BOX 20S1~, <br />~AI..EM~ ~73~7 <br />PHONE: 378-7454 <br /> <br />WATER SUPPLY <br />TEST HOI,.EB READY: NO <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIEL.~ LINES;: <br />SEPTIC TANK PUMPE~: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> I TEH QUANTITY AMOUNT <br /> STD OI,ISlTE SYS < 1000 GAl. 1 $255.00 <br /> C & R -- EACN ADDL. 508 6AL. DSF 1 `$',L5.~8 <br /> <br /> TOTAL ASSESSE9 FEES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br /> <br /> BALANCE DUE `$Q,, <br /> <br /> PAYEE: BROCE PACKING CO..~ ZNC RECEIPT NO: 52877 <br /> RECElVEO B~ 6L, ................................................... TYPE: CE CHECK ~: 27~ <br /> <br /> SEE ATTACHEQ DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE <br /> <br /> ~ THIS IS NOT A PEEHIT. THIS ~PLICAT[ON HUST GO THE~GH A REVIEW PROCESS ~E~E THE <br /> 0 <br />POLLOWING HU,,,T BE COHPLETED. ]:T IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL IIECE, SSARY INFORfiATION HAS BEEN PROVIDED., <br /> <br />PLAN REV:JEW, BY ..... DATE__. <br />REMARh. S,, SS:M JR TH:NO <br /> <br />OFFICE COPY <br /> <br />CITY JURISDICTION.., BY ............... DATE ...................... <br /> <br /> <br />