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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NC), 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 /> ) Other <br /> <br /> DATE: ~,~16/.'.,!4/93 Tif4F.':: 1:L : 57',; 09 <br /> L_ON(;,~ ~,iIi..i._:[AH i r RESIDENTIAL ' <br /> <br /> :1.1364 ~,iES ~Y SE : <br /> A,,%?¢I,L,,,,E OR 97S25 ; N COUNTY~ NO ~ <br /> <br /> ~UHSV:iJ...LE 97%25 SITE NUM~E~: ~3-~e6 <br /> ?HONE= 749-- :t. 22',:J VALUA'rZON: <br /> <br />LOT; mEoc~i ~b8~i6~-: ;' f6~'~'~ ~ F~; ~"~'; F~b'~ ~: <br /> <br /> ' 29 ' 8S ' .I.W ' Ak · <br /> , ] 6~i ] NI] <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERflZT OR APPLICATION <br /> <br />,,,ONIkAL lOk~ NO. <br />L. 0N(; ~ [~tLLiAM <br /> <br />AUMSVII,.LE 97325 <br />PHONE~ 749-:L225 <br /> <br />47475 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALLJAT]:ON NUHBER: 28248 <br />EX:t:SI"'ING TANK SIZE:: <br />IEX];STZNG ~RAIN PIEt,.,~ LINES: <br />SEPTIC TANK F'UMF'ED: <br />F'REVZOUS NO, BE:DROOff, S: <br /> <br /> ITEM QUANTITY AMOUNT <br /> STANDARD ON-SITIE SYSTEH 1 $255. <br /> <br /> -FOTAL ASSE, SSEI) FEES <br /> TN:~S REOEIPT <br /> BAL:~NCE DUE <br /> PAYEE:; RECEZF:'T <br /> <br /> SEE -,[1ACHI:,D ~0OIJMEN'T FOR ~EE~UI, EMENDS OF ON-SITE SEWA~E ,~Y,~ <br /> <br />ZON;~i,IG ORD:itFiANCES,~ THIS ~ I_RM.,.I ,~,4A,,.L ~,ECO~E NULL AND <br /> <br />..J,IA,.;) ;;;,. 1400DI,,.EY,~ '~IARIG% COUNTY ;!'UII.,DtNt]; OFFICIAL / BY <br /> <br />FOrM # MC 15-~6 R ~/. 4/~0 OFFICE COPY <br /> <br /> <br />