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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 performlrlg work on a property I own or occupy. <br /> <br /> DETROIT 0t~ ~7342 ', :OE'I'F~OIT ~ NO <br /> ..... 2 <br /> <br /> ~ HAMMOND ADDN <br /> 3~)91 DJ:I:kI[G AV NW <br /> SAI..,EM~ OR 97S~4 ~ SITE NUMBER: <br /> PHONE: 5~4,.-t~:L7 VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICAIIOH <br /> <br />[,ON FRAC FOR, <br />STRINGER., JIM & HANNELORE <br />~9:I, DEERING AV NW <br />$AI,,.EM~ OR 97304 <br />PHONE:~ <br /> <br />90~756~ <br /> <br />WATER SUPPLY: CW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 750 <br />EXISTING DRAIN FIELD I..INiES: <br />SEPTIC TANK PUMPED: 8,-,18,,.,92 <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITI{M QUANTITY AMOWNT <br /> AUTHOR];ZATION NOT.I,..,E - FLD, V,LSJ. T 1 $168. <br /> <br /> TOTAL ASSESSED FEES $!60~ <br /> PREVIOUS RECEIPTS <br /> THIS RECEIP'r $i68.90 <br /> <br /> BALANCE ~UE <br /> <br /> PAYEE~ Nor'w2! Richards IFI~OZCE NO: 498Z4 <br /> R[,CE1V~,Q ~Y,, PB ................................................................... TYF'E: IN CHECK ,~: <br /> <br /> SEE ATTACHE~ DOCUMENT FOR Id=,QUIRE~ENTS OP ON-SITE SEWAGE <br /> <br /> * THIS IS NOT A PERHIT. THIS APPLICATION flUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE CO~LLrED. IT IS THE RESPONSIBILITY OF THE AF'F'LZCANT TO ASSURE THAI' <br />ALL NECESoA,~¢ 1Mt O~,~AI.[ON HAS BEEN PI'.~OVIDE~. <br /> <br />REMARKS: <br /> <br />FOnM# MC ~s.,~ ~v, 4~ O~HCE COPY <br /> <br /> <br />