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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO. 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />PHONE:588-5147 8;00- 4'30 <br /> <br />OAT~: 05/31J90 TINE= 13~20:39 <br /> LYON~. H~R'OLD <br /> <br /> RET51 DEN '1 ] <br /> <br />MARI~N ~OUNTY NO <br /> <br /> 4 <br /> <br /> 7478 E:H6RNAN RD <br />AuFF~ViLLE OR 97325 <br /> <br />~A~E <br /> <br />.,iD <br /> <br />:29 <br /> <br /> 0.5 <br /> <br />PERNiT OR APPLICAIION NO: 9024~76 <br /> <br />C~NI~TOR. NO. 34916P'-2 <br />...SYAYTON MILL CZrY SILVERTON SEP <br />43155 5'FAYTON DC;lo DRIVE, SE <br /> STAY¥ON, OREGON 97383 <br /> PHONE: 769-2302 <br /> <br /> SiTE NUNI~ER: 10303 <br /> VALUAT ION: <br /> <br /> 85 lW <br /> AC NO NO <br /> <br />I,'~TER SUPPLY: <br />TI~ST HOLE~ READY: <br />SiTE E'VALUATICN <br /> <br />~EPTIC TANK PtJNPED: <br />PREV[OU~ NO. BEDRO(~IS: <br /> <br /> (.7J~¢~TITY <br />ALI EI:~AI'IO~ 1 <br /> <br />TOTAL AS.SES,.~ED FEES <br />PREVlOUS REC~IPT~ <br />THIS RF...CEiPT <br /> <br />BAI.,,/~CE DUE <br /> <br />PAYET~: STAY[~ MILL C[ [Y StLVERTON ~EPTIC <br /> <br />REff3~iPT NO= <br /> <br />k4Af~ <br /> <br /> Ar,'louNr <br /> <br /> $145.oo <br /> $o.0o <br /> $~45.o0 <br /> <br /> $0.0o <br /> <br />25926 <br />5062 <br /> <br /> RECEIVED DY= CL TYPE~ CK CHECK <br /> <br />~ THIS J$ NOT A PERt~IT. THiS APPL]CAT[ON I~LI~? ~ TI,tRI~J~H A REV[IEN PROC~iNHEf~ THE <br />I:;OLLO~JNG iVlUST ~E CC~PLETED. IT [~ THE REENoiDNSfBII..J.I"FOF TH~ APPLICANT TO ~IS~URE THAT <br />A[~ NI:'~:~E~SA~ iNFORII~AT[ONI'tAE,~EEN <br /> <br /> RP]~ARKS= ALTERATION- P_D(JSTING ON NE[G~F~S NEAR <br /> <br />OFFICE COPY <br /> <br /> <br />