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MARION COUNTY BUILDING INSPECTION <br />SENATOR .BtDG:'N©, 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 /> of ~ recji~tered <br /> The work will be perlormed by a resistered builder. <br /> <br /> ) I have read ~t~d au to the terms stated on the reverse side of DATE; <br /> <br />~ ~l~u~ ADDRE~: ~: OCCUPANCY: <br /> <br />~ ~[80 SHZTH RD SE " ~ oCCUPAnT <br />:~ ~UHSVZLLE OR ~7~25 ,~UNTY ~: <br /> <br /> ~A~LING A~DRESS~ ~ SUBDIVISION: <br /> <br />9032 SHITH RD SE <br />AUMSVILLE, OR ~'~""~00 <br />PHONE: 74~-2345 : VALUATION: <br /> <br /> ~§E~: !~dYi~H; ~Y~i~[ i ~A~i : ZONE: MAP: <br /> ! 24 ,! 8S ; 2N ; SA 51 <br /> <br />TYPE: ON-SITE SE#AGE <br /> <br />PERH[T OR APPLICATION NO: <br /> <br />CONTRACTOR~ NO. <br />SMITH. PATSY <br />90~2 SNITH RD SE <br />AUMSVILLE~ OR <br />PHONE: 74~-2545 <br /> <br />420Z6 <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, EA. ADDL.' LOT <br /> <br /> ,:TOTAL ASSESSED'FEES $185~00 <br /> PREVIOUS'RECEIPTS $185.00 <br /> THIS.RECEIPT $0.00 <br /> <br /> BAb~NCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: c] ...... ~.~,-:- _ ....... TYPE: CHECK ~: 0 <br /> <br />NOTE: THIS DOES NO~ GRANT,,OR,.IHPL,Y','/PERM~$S~,ON ~O:SUILO ON THIS PARCEL. PLANNING AND <br />ONSTRUCTION PERHIT$ HUST BE OBTAINED BEFORE'BUILDING OR SEPTIC INSTALLATION BEGINS. <br /> <br />REMARKS: SE/ std system <br /> <br />DONALD E. NOODLEY. MARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15-5~ R~V, <br /> <br /> <br />