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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HI.GH STI~EET 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 ~,m a registered builder OR ( the authorized representative <br />of a registered builder, <br />The work wiJl be performed by a registered builder, <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document. <br /> <br />DALE: 05/20/94 lIME,", ~j:~2:02 ~ <br />~,d~§§~WELLS ~USSF. LL ~'0~i:~0~'~i~741180~0 ~f~'~ ', RE~ I I)ENT l'. Al.., ~ Occu~,. <br /> <br /> V{~E{~ANE ~ - : "0 OF BEDROOMS: <br /> ~mSVILLE OR ~7325 flA~ION COUNTY NO '. <br /> <br /> P 0 BOX 28B I THE RANCH <br /> 4.6~ AC NO NO <br /> <br />TYPE: OH-SITE SEWAGE WATER SUPPLY <br /> TEST HOLES READY: <br />PERHIT OR ~PPLICATIDN NO: 54~168 SITE EVALUATION NUMBER: THE RANCH <br /> EXI.STING.,TANK,SIZE: <br />CONTRAOTOR. NO. 5~586 ,,~ ~ EXISTING ~RAIN~FIELB LINES~ <br />CANYON CONSTUCTION i SEPTIC 'TANK PUMPE~: <br /> <br />P 0 BOX 57.... ~ PREVIOU~ NO. BE[~ROOMS: <br />STAYTOII= 9738~ · ? ~: ' <br />PHONE: 769-2§84 ' <br /> <br /> ITEM <br />STANDARD ON-SITE SYSTE'M <br /> ~'~ <br /> rS:: <br /> <br />QUANTITY AMOUN'f <br /> 1 $255,00 <br /> <br />$25%,00 <br /> $0.00 <br /> <br /> PAYEE: RECEIPT flO~. <br /> RECEIYEI) BY: XXX :,:i TYPE: CHECK ~: 0 <br /> SEE AI'I'ACHED DOCUMENT <br /> <br />$ THIS IS A VALID ~ROH ITS ISSUE DATE. IF <br />CONSTRUCTION FALLS TO MARION COUNTY BUILQING AND <br />ZONIN6 OEDINANCES~ ;,: <br /> <br />RE.i'IARK(3:: S'FANDARD SYS'fR~'M 'WITH: dP'-$1Jt;~'PE cuR'If'A::[N )DRAIN, SCL; SITE F'LAN 5/:LS/94,. <br /> , ,~ ,,~ ,, f ,.,,' <br />OdNALi') E. IdKIOQI.,,EY~ MARIOh OOJC, l'Y BJILD[N6 OFFi[CIA., /)BY ................... .[[,_ ,,~,~_ ............................ <br /> <br />FORM # MC 15-56 REV, 4/80 OFFICE COPY <br /> <br /> <br />