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SENATOR BLDG. NO. 225 <br /> 220 HIGH STREET NE <br /> SALEM,.OREGON 9'7301 <br /> <br /> PHONE 588-5147 <br />CODE-A~PHONE 4 30 PM_ - 8130 A M. <br /> <br />o'~I~'I"E~. 0S/'22/8g Tlfl4E: 3=50: 151= <br /> <br />$~..,.o~=,~.~TAN L EY. CLYDE <br /> <br /> TAX kOT <br /> <br /> oo,s'm~c'r ,::~,~ ~ 62149-?69 <br /> <br />MARION C~UNTY NO <br /> <br />97 <br /> <br /> 91~9 STAYTON ROAD SE <br /> AUMSVILLE 97325 <br /> PHONE: 769-~466 <br />LOT I~0CK <br /> <br />TOWH~HIP <br /> <br />SITE <br /> <br /> 33 u~s ~ m~U~T 2W c.O~, <br />1.85000 ~ YES ~ <br /> <br />TYPE: ON-SlTESE~ <br /> <br />PERf,IIT OR APPLICATION NO; <br /> <br />CONTRACTOR, NO. <br />STANLEY. CLYDE <br />9119 STAY'I'ON ROAO <br /> <br />At. JIv~V~LLE 9?325 <br />PHONE= 759-4466 <br /> <br />13570 <br /> <br />IHATER SUPPLY: <br />TE~T HOt. ES READY: <br />SITE EVALUATION NUMBER: <br />EXISTIN~ T.elK SIZE= <br />EXISTIN~ DRAIN FIELD LINES: <br /> <br />PRL:VIOJS ~K). ~. <br /> <br />6497 <br /> MAP <br /> <br /> AE 65 <br /> <br /> ITEM QUANTITY N~OUNT <br />SITE EVALUATICiq, FIRST LOT 1 $17S,00 <br /> <br />TOff~l. A--~E,E~iED FEES <br />PIk=VIOU8 RECEIPTS <br />THIS RE)C~IPT <br /> <br />$175.00 <br />$175,D0 <br /> $0.00 <br /> <br />BAL, e, NC~ IAJE $o.00 <br /> <br />PAYEE: <br />RECEIVED I~Y* CL TYPE: <br /> <br />CHECK <br /> <br />NOTE= ~IS 00~ NOT ~ O~ IMPLY P~IeeI~N TO ~UILD ON THIS PAI~. PLANNING <br />(X;~N~rRUCTI~ I:~i~TS I~LIS'TBE OBTAINED BEFO~ 8UILOII~ OR SEPTIC INSTALLATION BE~II~. <br /> <br />RF. NARKS: SITE E'VAL R~5380 SANO FILTER <br /> <br />DONALD E. i~DODLEY, I~tARION CO.,~iTY I~JILDI~ OFFICIAL / BY <br /> <br />O~lCl~ COPY <br /> <br /> <br />