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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLD(~. NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />~TE: 01/02/89 <br /> <br />RESIDE <br /> <br />2 <br /> <br />PHoN~: <br /> <br /> 271 380 <br /> <br />TYP~: ON-SITE <br /> <br />PERMZT OR APPL~CAT~CN NO: <br />03NTRA~TO~, NO <br /> <br />~E: 749-1503 <br />IT~ <br /> <br />9013282 <br /> <br />ANNUAL EVAL. - TEMP OR HIDSHP NH <br /> <br />SITE NU~lSER '. 6289 <br />VALUATION: <br /> <br /> 2W AR 51 <br /> <br />NATER -~JPPLY: PW <br />TEST HOLDS I~J~DY: <br />~IT~ ~A~AT~ N~ER: <br />~ISTI~ T~K SIZE: <br />~ISTING D~IN Fi~O <br />SEPTIC T~K ~M~D: 1~-26-86 <br />PREVI~S NO. <br /> <br />TOTAL A,GS~ED FEDS <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$60.00 <br /> $0,00 <br />$$0~00 <br /> <br />BALANCE DUE $o.oo <br /> <br />PAYEE: F-OREM,~.N, 'TRERE:F~A ,,,';/~__.~- RECEIPT NO: ~080 <br /> TYPE: CK CHECK #: 1701 <br />RECEIVED,_~ .... BY: ~P~ ......... :~ ~'~ ~-.~--.---- ....... <br />SEE ATTACHED DOCUMENT FGR ~IRENtENTB OF ON-SITE SEWAGE SYSTEM. <br /> <br />FOLL.i~ZNG i~ST BE COMPLain. ~T ZS 'THE RI~NSZGZL~TY OF THE APPLZCANT TO ASSURE 'THAT <br />ALL NE~ [NFOENATZON HA~ BEEN PROVZDED, <br /> <br />RENARKS: ANNUAL HARE~NIP SEPTIC INSP F~688 <br /> <br />FORM , ~ ~;~ ~-~ H~ OFHCE COPY <br /> <br /> <br />