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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing WOrk on a property I own or occupy. <br />l am a registered builder OR ( )theauthorlzedrepresentatlve <br />of a registered builder, <br />The work wlll be performed by a registered builder. <br />Other. <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this docur,3 ent, <br /> <br />OWNEn: DATE: 02/01./95 TIME: i,f,,~X. LOTi iDAYEGORy~ <br /> CALi[F. iNVESTORS CORP~ ,I 67009-521. ,: RESIDENTIAL <br /> SITUS ADDRESS: ~ O~}NS1-R'u~iON T~P~,. ;OCCUPANCY; <br /> <br /> 220 HILL ST <br /> DETROIT <br />USE OF BUILDING: <br /> <br />PO BOX 491.451 <br />L.A. CAL 90049 <br />PHONE: 244-1353 <br /> <br />SITE NUNBER: 93-00394 <br />VALUATION: <br /> <br />LOT: BLOCK: 'SECTION; <br /> <br />WIOTH: DEPTH: ARE~ UN,TS;~O ~ IRR~¢LOT'. I; N~CO~ ~ : ~0~ <br /> s S; ............ L__ <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: 9045078 <br /> <br />CONTRACTOR, NO. <br />CALIF. INVESTORS CORP_ <br />PO SOX 491451 <br />L.A. CAL 90049 <br />PNONE; 244--1333 <br /> <br />WATER SUPPLY: CW <br />TEST HOLES READY; YES <br />SITE EVALUATION NUMBER; <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC ~ANK PUMPED: <br />PREVIOUS NO. BEDROOMS; <br /> <br /> ITEM QUANTITY AMUUN <br />SITE EVALUATION, FIRST LOT 1 $220.00 <br /> <br /> TOTAL'ASSESSED FEES $220_00 <br /> PRE~IOUS RECEI°TS $0.00 <br /> THIS RECEIPT $220 00 <br /> <br /> 8ALANCE DUE $0.00 <br />PAYEE; CALIF. <br />RECEIVED BY: MB I~_~_~.~ -2- INVOICE NO: 47254 <br /> .............. ~ ...... 'YPE: Ih CHECK ~: 0 <br /> <br />SEE ATTACHEO DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM_ <br /> <br />NOTE: THIS DOES NOT GRANT OR IMPLY PERMISSION TO 8UILD ON THIS PARCEL, PLANNING AND <br />ONSTRUCTION PERMITS MUST BE OBTAINED 8EFORE BUILDING OR SEPTIC INSTALLATION 8EGiNS. <br /> <br />PLAN REVIEW: 8Y ..... __ DATE... _ CITY JURISDICTION; BY ........ OATE ....................... <br />REMARKS: SITE EVALUATION <br /> <br />OFFICE COPY <br /> <br /> <br />