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MARION COUNTY <br /> BUILDING INSPECTION <br />~ Higl~ Street NE o Second Floor · Salem,, Ore~ 97301-~670 <br /> 4:30 Pho~; ~8~-5147 24 Hoar C~A-Phon~:: 58g.7~ <br /> <br />DATE= 04/20/g0 TIME: 14=56'-S5 <br /> <br /> DORt..N~D. LARRY <br /> <br />RESIDENTIA[ · <br /> <br />97342 <br /> <br />NE <br /> <br />MARION COUNTY NO <br /> <br />RT 3 ~OX 460 <br />HILL~qSORO, OR 97124 <br />PHONE: 647-2980 <br /> <br /> DEVIL'S CREEK ~JI~t~ER TP, ACTS <br /> <br />SITE NUF~ER '- 9963 <br />VAUJAT ION: <br /> <br />104 <br /> <br /> 120 <br /> <br />165 <br /> <br />21 9~ 1E TC <br />19000, SF NO NO <br /> <br />102 <br /> <br />TYPE: ON-~ITE <br /> <br />PEI~IIT OR APPLICATION NO: <br /> <br />C~NTRACTOR, NO. <br />DORi. J~D, LARRY <br />ET ~ OOX 460 <br />HILLEISORO, OR 97124 <br />PHONE: <br /> <br />:002~406 <br /> <br />WATER SUPPLY= <br />TEST HOLE~ READY= <br />SITE EVALUATION NUMSER~ <br />EXISTING TANK SIZE: <br />EXISTIN~$ DRAIN FIELD LINES: <br />SEPTIC TANK I~MPED: <br />PREVI(~JS NO. BEDROOMS: <br /> <br /> G~J~NT[TY <br />/~DTHORIZATION h~TICE - NO VISIT 1 <br /> <br />TOTAL ASSE~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />PAYEE= DO~PJ~. D, LAP~ <br />RECEIVED $Y. el TYPE= CK <br /> <br />RECEIPT NO= <br /> OqECK ~: <br /> <br /> sac. 00 <br /> <br /> $60.00 <br /> $0.00 <br /> $60.00 <br /> <br /> $o.oo <br /> <br />247~9 <br />1034 <br /> <br /> SEE ATTACHED [X~2IJ~NT FOR REQUIRE~T~ OF ON~ITE E~NAGE ~T~. <br /> <br />~I~ ~~. '~T IS~E ~IBILI~,~E~I~T TO~ <br /> <br /> R~R~= ~TEE ~, ~U~ C~EK- PZT PE~V~~' <br /> <br /> <br />