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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO.. 225 <br /> 220-HIGH .~TREET NE <br /> · . SALEM, OREGON 97301 <br /> <br /> PHONE 585~5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />OAT& <br /> <br /> CATEGORY <br /> <br /> ~ZAL <br />' OCCUPANCY <br /> <br />P.O- BOX 290 / REX LUCA~ <br />AUNSILLE, OR 9?325 <br />PHONE: 799-3576 <br /> <br /> SITE NUMBER~ 8591) <br />.= ........... b[O NO <br /> <br />MAP: <br /> <br />TYPE: ON-SITE ~EWAGE <br /> <br />PER)'4)T OR APPLICATICN NO~ <br /> <br />CONTRACTOR, NO. <br />SENE~. STEVE~ BLAINFaD( <br />P.O. BOX 290 / <br />AUMSILLE. OR 97325 <br />PHONE= ?49-25?$ <br /> <br />WATER ,.~JPPLY: PIN. <br />TE~THCA.E~ RF~,DY. <br />SITE EVALUATION <br />EXISTING TANK SIZE: 1000 <br />EXIt"TING DRAIN FIELD LINES: <br />SEPTIC TANK PUNPED~ HILL BRING <br />PREVICUSNO. BEDROOMS: <br /> <br />225 <br /> <br />PAYEE.' SEN <br />RECE;IVED <br /> <br />ESEE <br /> <br />QUANTITY <br /> 1 <br /> <br />  RECEIPT NO: <br />x>o< ........ TYPE-' CA CHECK <br />DOCURENT FOR RE(~iI'EmENTS OF ON--~'I'TE SEWAGE <br /> <br /> Nvi(~NT <br /> $60.00 <br /> <br /> $60,00 <br /> $o,oo <br /> $60,00 <br /> <br /> $0.00 <br /> <br />21689 <br /> 0 <br /> <br /> NOT A PEM~IXT. THTS APPLiC~TI(~I- Rb'T A I:~VZE~ P~ I,I-IEi~ THE <br />~ BE CO~&~I.ET~D. 'IT IS'THE- REEhc,(INsIBILITY OF 7HE APPLICANT TO ASSURE THAT <br /> INPO~TI(]N H~ BI~N PROVIi~. <br /> <br />PLAN REVIEW: 8Y__~ DATE CITY JURISDiCTiON: BY ......... DATE , <br />REMARKS= AUTH FOR MEAT E,I..IOP TO EXlSTIN~ RE~ SYSTEM <br /> <br /> <br />