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MARION COUNTY I~.ULLD. ING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: B88-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: B88-7904 <br /> <br /> of a registered builder, <br /> The work will be performed by a registered builder, <br /> Other. <br /> <br /> DATE: 09/05/92 TIME: 10:14:.50 <br />;oWN~n'. <br /> <br />i ~TUS ADDRE~ ~ ~ONSTRUOTION ?YPE~ ~ 66t6P~dg: <br /> <br />~ 9250 SMITH RO SE : <br />I AUMSVILLE 0R 97~25 ~6~'~O~f~OUNT~66~O ;OCCUPANT LOAD: <br /> <br />!LOT: <br /> <br />I'G7i'~i~6'~66~i ..................... su~mv,mo~: <br /> <br /> 90~2 SMITH RD SE <br /> AUMSVILLE, OR 97325 ~ITE"HUMBER: <br /> PHONE: 749-2~45 VALUATION: <br /> <br />92~02999 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />SMITH, HAROLD M <br />90~2 BMITH RD SE <br />AUMSV~LLE, OR 97325 <br />PHONE. 749-2~45 <br /> <br />420Z4 <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 QUANTITY AMOUNT <br />SITE EVALUATION. FIRST LOT 1 $220.00 <br /> TOTAL ASSESSED FEES $220.00 <br /> PREVIOUS RECEIPTS $220100 <br /> ~ THIS RECEIPT $0.00 <br /> BALANCE DUE $0.0o <br /> <br />PAYEE: RECEIPI NO: <br />RECEIVED BY: c] ................. ~ M TYPE: CHECK <br /> <br />SEE ATTACHED DOCUMENT FOR.REQUIREMENTB OF ON-SITE SEWAOE SYSTEM. <br /> <br />MOTE: THIS DOES NOT GRANT OR IMPLY PERMISSION TO BUILD ON THIS PARCEL. PLANNING AND <br />ONSTRUCTION PERMITS MUST BE OBTAINED BEFORE BUILDING OR SEPTIC INSTALLATION BEGINS. <br /> <br />REMARKS: SE / std sYstem ' <br />DONALD E. WOODLEY, MARION couNTy B~ILDIN~ OFFICIAL / BY <br /> <br />OFFICECOFY <br /> <br /> <br />