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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-AiPHONE: 588-7904 <br /> <br />DATE: 12/~9/94 TIME: 15:01:14 <br /> <br /> ~UMSVZL. LE7732 75TH PL OR 9732sSE ~~Ty N~B: 'IOOOUPANT LOAD: <br /> <br /> 5281 HOWELL PRAiRiE RD NE 97381 SITE NUHB~R: 94~217~ <br /> PNONE= 87,-114~ } VAI. UAT~ON. <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNIT OR APPLICATION <br /> <br />CONTRACTOR., NO,, <br />ALI,.EN~ KEVIN <br />KlM ALLEN <br />5281 HOWELl.. PRAIRIE RD <br />PHONE: 873-1144 <br /> <br /> WATER SUPPLY: PW <br /> TEST HOLES READY: <br />Ho: 9~6~8ta SITE EVALUATION NUMBER: 55468 <br /> EXISTING TANK SIZE: <br /> EXISTING DRAIN FIELD LINES: <br /> SEPTIC TANK PUMPED: <br /> ~REVIOUS NO. BEDROOMS: <br /> <br />:' :, QUANTITY <br /> <br /> ITEM <br />SAND FILTER <br /> <br />PAYEE: <br />REEEIVED BY: CL <br /> <br />SEE ATTACHED OO£UMENT <br /> <br /> * THIS IS HOT A PERHIT.'::: <br />FOLLOWING MUST BE <br />ALL NEOESSARY INFORMATION~, <br /> <br />AMOUNT <br /> $480.00 <br /> <br />$480.00 <br />$480.00 <br /> $0.00 <br /> <br />$0,00 <br /> <br />; RECEIPT NO: 0 <br />;.:TYPE: C, HECK <br /> <br /> TEM. <br /> <br />:A REVIEW PROCESS WHERE THE <br /> APPLICANT TO ASSURE THAT <br /> <br />PLAN REVIEW: BY DATE CITY JURIS~)ISTION: BY ....................... DATE .................... <br />REMARKS: SAND FIL.'I"I~R <br /> <br />OFFICE COPY <br /> <br /> <br />