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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 />I am a registered builder O1~ ( the authorized representative <br />of a registered builder, <br /> <br />Other_ <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document. <br /> <br /> DAYS;: 02/18/'93 T~hE; <br />OWNER: <br /> <br /> I-tXL,L,~, HAROf_C & YVONNE <br />SfTUS ADDRESS: <br /> <br /> 67003,~000 <br />CONSTRUCTION TYPE: <br /> <br /> RESID;:NTIAi, <br />OCCUPANCY: <br /> <br /> 19.5 BUYMOORE OR , ~0N~RAO+c/-Y: O~CUPAN'r LOAD: <br />BETRO)']' OR 97342 DETROIT <br /> <br />PO BOX 463 <br />DETROZT OR 97342 SZTE ~UNB~R: <br />PHONE: 854-344~ V~LU~TZON: <br /> <br /> :L3 O1 ;~. ~/ ~ .SER~S <br /> 2J J, 114 2/40541 NO <br /> <br /> TYPE: ON-SITE SEWAGE '~ ~/¢AI'ERSUPPLY: <br /> TEST HOLES READY: <br /> PERH[T OR &PPL[CAT[OH NB: SLfE EV~LUA'f[OH <br /> EXZST~NG TANK S~ZE; 500 <br /> CONTRACTOR, NO. . EXZST[NG DRA[~ FZELO <br /> BILLS, HAROLD & YVONNE SEPTZC T~NK PUNPEO: <br /> PO BOX 453 PREVIOUS NO,. 8EOROOH$: <br /> OETROll' OR 97542 <br /> PHONE; 8S4-,.~441 <br /> <br /> TOTAL ASSESSED rEES <br /> PREVIOUS RECEIPTS $0.,)0 <br /> <br /> L~AF BALANCE f)UE $0,.00 <br /> PAYEE: IfllI._ ~OL, O & YVONNE ~ INVOICE <br /> <br /> SEE ATTACHED OOCUMENT FOR REQUIREMENTS OF ON-SiTE SENAGE SYSIE~. <br /> <br /> $ THIS IS NOT A PERMIT. THIS APPLICATION ~UST 60 THROUGH A REVIEW <br />FOLLO~ING MUS/' 8E COMPLETEO. IT IS IHE RESPONSIBILITY OF THE APPLICANT l'O A~;BL.IR(: 'FHAI' <br />ALL NECESSARY iNFORMATION HAS BEEN PROVIDED, <br /> <br />LOT: <br /> <br /> 2 <br /> <br />I:~LAN REVI~iW: BY ............... DATE ....................... CITY ,TURISD:[CFION'. lirY ............... <br /> <br />REfIAP. KS: AU'IH NO VlS[] P~R PHONE ~L,L ~ITH LEE <br /> <br />OFFICE COPY <br /> <br /> <br />