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MARION COUNTY <br /> B[!ILDING INfiPI-('TION <br />220 HiBh $~r¢c~ NF · -¢~-'<ond I-lOOT $ .~l/~m. Ore,on 9~3,1j.3~7(i <br /> <br />4 30 Phone ~8~314a C'~A-Ph0~c 4 30 p m - ~ (~ a m <br /> <br />BILL <br /> <br />5650?-000 <br /> <br />RESIDENTIAL <br /> <br /> 11972 5TEINKAMP RD <br />AUM~VILL~ OR 87325 <br /> <br />SE <br /> <br />11852 STEINKAr~ RDSE <br /> <br />$ITE NU~ER: <br /> VALUATICDQ: <br /> <br />6692 <br /> <br />261 298 <br /> <br /> 33 85 <br />77778.0 SF NO <br /> <br />NO <br /> <br />'r'YPE: ON-SITE SEbgM~E <br /> <br />PERMIT OR APPLICATION <br />CC)NTRACTOR, NO. <br />NOLIEI~S. BILL <br />11852 STEIN~ R~ SE <br /> <br />PHONE: <br /> <br />14384 <br /> <br />I~ATER ~JPPLY: <br />TEST HO~ READY~ YES <br />SITE EVALUATION N~ER: <br />EXISTING T~NK SIZE: <br />EXISTIh~ DRAIN FIELD LINI"~: <br />~PTIC TANK ~: <br />PR~VIOU~ NO. <br /> <br /> ITEM QUANTITY <br />SITE EVALUATION, EA. ADDL. LOT 1 <br /> <br />TOTAL A~SED FEES <br /> <br />8AI..ANC~ 0UE <br /> <br />RECEIPT NO: <br /> <br />$1as.oo <br /> <br />~145.00 <br />145.00 <br /> $0.00 <br /> $0.00 <br /> <br />RE~CEIVED BY: ~l TYI:~: CHECK It= <br /> ATTACHED {XX~bl~li~T FOR REQUIRI~M~ OF (~I'rE ~ SYSTEM. <br /> <br />~OTE: ]?tis DOES NOT ii, htr OR X~Pt.Y PE;~IISSiON TO BUILD ON THIS PANEL. Pt.N~NG AND <br />(XiqSWRIX,'TION PERNIT~ 14JSr BE C~TAINEI) $~:~3~ BiJILDIN~ OR I~iFTIC INSTALLATION <br /> <br />REMARKS: SE R~896 STD S~T~ ~ <br />00NALD E. NOOOLEY,, MARION COJNTY SUILDING oFFICIAL / BY ......... <br /> <br /> <br />