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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: 568-7904 <br /> <br />of a registered builder, <br />The work will be performed by a registered builder, <br /> <br />i have read and agree to the terms stated on the reverse side of <br /> <br />',~WNER: ~A']L :J.O/:tO/9; TIME, -9,'-~.9:.2,j ;TA~I~dT~ ................... 18,~f~EGR,~:' <br /> HCI_AUGHLAN~ ROBERT i J ~i:;'S'[DENTZ~L <br /> <br /> AUHSVILLE OR 97;2o COUNTYL NO j ~ <br /> <br /> SAME ............................................................................ <br /> PNONE: 769-~124 VALUATION: <br /> ;Cf ~[ock S~Ct ~ F?~-~ F~' ~r. ............ ~ .... ~; .............. <br /> <br />TYPE: OH-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />M~LAUGHLAN~ ROBERT <br />SAME <br /> <br />PHONE: 76~-3124 <br /> <br />9~49716 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: YES <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QIJANTITY AMOtJNT <br />SITE EVALLIATION. FIRST LOT i $265.00 <br />AU'rNORIZATION NOTICE - FLD. VISIT t $160.00 <br /> <br /> TOTAL, A~S~SSED FEES <br /> 'PREVIOUS. ~ECEIPTS' / $520.008425"00 <br /> <br /> BALANCE ~UE v $0..00 <br />PAYEE: MCLAUGI4LAN, ROBERT RECEIPT NO: 5~12~ <br />REBEIVED BY: CL TYPE: OK CHECK ~: 0 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS 'OE ON-SITE SEWAGE SYSTEM. <br /> <br />NOTE: TI-ITS BOES NOT GRANT OR IMPLY PERMTSSION TO BUILD ON TFIIS PARCEL. F'LANNING <br />OI,ISTRUCTION PERMITS NUST BE OBTAINED BEFORE BUILDING OR SEPTIC INSTALL, A'~ION <br /> <br /> PLAN kI--VIEW,, BY DATE _.. CITY JURISD,[CTION,, BY I)Al'L< <br /> <br /> REMARKS: SE- AF'F'ROVED FOR SAND FILTER, GOING TO USE EXIST:lNG SYSTEM <br /> <br />~o.a ~ uc ~s,~ ~L-V. 4~o OFFICE COPY <br /> <br /> <br />