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MARION COUNTY BUILDING INSPECTION <br />SEi'~ATOR BLDG- NO. 225 <br />220 HIGH STREET NE <br /> SALEM= OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P_M. - 8:00 A_M. <br /> <br />The work will be peHormed by e registered builder <br /> <br />HOS'TETLER, DAN~[EL & J.N',IET <br /> <br />40512-000 <br /> <br /> 14593 OTTA~,Y ~O NE <br />AURORA OR 9'7002 <br /> <br />CONTF~ACT CITY IJGg <br /> <br />OCCUPANT LOAO <br /> <br />P.O. BOx 655 <br />CANBY, ORE 97013 <br />PHONE: 263-1993 <br /> <br />SITE NUMBER: 9011 <br />VALUATION: <br /> <br />MAP <br /> <br /> 13 <br />WIOTH DFFTH AREA <br /> <br /> ¢91 1097 53862"/. <br /> <br />SF NO NO <br /> <br />TYPE: CN-SITE SENAGE <br /> <br />PE~IV~IT OR APPLICATION NO: <br /> <br />CONTPJ~CTOR, NO. <br />HC~TETLER, DANIEL & JANET <br />~.O. BOX 656 <br />CANSY, ORE 97013 <br />PHONE: 253-1993 <br /> <br />20705 <br /> <br />NATER SUPPLY: C~ <br />TEST HOLES READY: NO <br />SITE EVALUATION NUMBER= <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES= <br />SEPTIC TANK PUMPED~ <br />PRE¥I~XJS NO_ BEDEOOF~,.. <br /> <br /> ITEM <br />STD ONSITE SYS < 1000 GAL <br />SITE EVAL. - FIRST 1000 GAL DSF <br /> <br />PAYEE: <br />RECEIVED ~Y~ P~ <br /> <br />BALANCE DUE <br /> <br /> TYPE <br />SEE ATTACHED I:X:X:~MENT FOR RE'Q[.IIRENENT$ 0~ ON-~ITE SENATE SY~TE~I. <br /> <br /> (~ANTITY AFOJNT <br /> 1 ~65.00 <br /> 1 $175.00 <br />TOTAL AE~,~D FEES $340_00 <br />PREVIO.~ REDE[PTS $175.00 <br />9'HIS RECEIPT $165.00 <br /> <br /> $o.oo <br /> INVOICE NO: 23135 <br /> CHECK ~: 0 <br /> <br />~ PAI:;~CEL. PLANNIN~ AND <br /> IN~9'ALLATI(~ BI~INS. <br /> <br />OFFICE COPY <br /> <br /> <br />