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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 />~ I am performirlg work on a property I own or occupy. ~"~ ~ ~~ <br /> I am a registered builder OR ( ) the authorized representative 8,1GNATURE OF APPLICANT <br /> Of a gegistered builder, <br /> The work will be periormed by a registered builder. <br /> Other <br /> I have read and agree [o the terms stated on the reverse side of DATE'. <br /> this document. <br /> <br /> DATE. 0?/20/93 'IIME. i6.10.34 ........................... <br /> <br /> AURORA OR 97ee2 MARION COUNTY <br />,USE OF BULDN~r ' ................ ' - <br /> <br />SAME <br /> <br />PHONE: <br /> <br />782-9217 <br /> <br />SITE NUHBER: ~3-025~2 <br />VALUATION: i <br /> <br />TYPE: OH-SITE SEWAGE <br /> <br />PERfllT OR APPLICATION NO: <br /> <br />CONTRACI'OR~ NO. <br />BAILEY, JA~ES <br />SAME <br /> <br />PHONE: 982-~217 <br /> <br />9048~71 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES BEADY: YES <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING BRAIN FIEL~ LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOONT <br />STANDARD ON-SITE SYSTEM 1 $255.00 <br />SITE EVALUATION, FIRST LOT 1 $265.00 <br /> <br /> PBEVIOO8 *ECEIPT8 <br /> TNIS. RECEIPT $s~o.oo <br /> <br /> BALANCE DUE $0.80 <br /> <br />PAYEE: LAPRANCE~ MARGARET RECEIPT NO: 5089~ <br />RECEIYEB BY: CL TYPE: CK OHECK ~: 29~ <br />SEE ATTAONEB BOCUMENT FOR'REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />NOTE: TNIS DOES NOT GBANT OR IMPLY PERMISSION TO BUILD ON THIS PARCEL. PLANNING AND <br />ONSTRWCTION PERMITG/~llJ~T~BE OBTAINED BEFORE BUILDING OR SEPTIC INSTALLATION BEGINS. <br />~,..AN REVIEW, BY .... ~ ..... ~ATE_J:~=~____ 0ITY ~URISDICT'ON: BY .......... DATE <br />REMABKS: SE/SS <br /> <br />'G~M* MC ~s.ss Rev, 4/~o OF FICE COPY <br /> <br /> <br />