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MARION COUNTY~ BUILDING INSPECTION <br />SENATOR BLD~ NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />DATE: 08/27/92 TIME: L~:[4:$5 <br />3TONELAKE, WENDELL & NELDA <br /> <br /> I CX41o <br /> ~ CHAHPOEG ROAD <br /> AURORA, OR <br /> <br /> PHONE: 588-5147 8:DO - 4:30 <br />24 HOUR CODE-A-PHONE: 5~8-79o4 <br /> <br /> PHONE: 678-2L7D <br /> <br /> 6 45 <br /> OeP?W ~nEA - ~;f~: ........ <br /> 7.4 ' Ag <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERHI¥ OR APPLICATION NO: <br /> <br />CONTRACTOR~ <br />STONELAKE, WENDELL & NELDA <br /> <br />Ph{ONE: 678- 2,],, 70 <br /> <br />SITE HUI'IBER: 92~00456 <br />VALUATION: <br /> <br />NO NO <br /> <br /> wATER SUPPLY: PW <br /> TEST HOLES READY: <br />9042Z85 SITE EVALUATION NUMBER: <br /> EXISTING TANK SIZE: <br /> EXZST~M80RAIN FIELD LINES: <br /> SEPTIC TANK PUMRED: YES <br /> PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM % QUANTITY AMI)UNY <br />ANNUAL EVAL. -- TEHP OR HOSHP HH '... 1 $75.00 <br /> TOTAL ~SSE'DSED FEES $75.00 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $75.00 <br /> <br />BALANCE DUE $0_o0 <br /> <br /> PAYEE: 8TOHELAKE, WENOELL& NELOA RECEIPT NO: 44242 <br /> RECEIVED 8¥: PW TYPE: CE CHECK ~: 3~1i <br /> <br /> SEE ATTACHEO DOCUMENT FOR REQUIREMENTB OF ON-SITE SEWAGE SYSTEH. <br /> <br />* ~HI$ I$ HOT A PERHIT. THIS APPLICATION HUST GO'THROUGH A REVIEW PROCESS ~HERE THE <br />FOLLOWING HUST 8E OOMPLETEO. IT I~ THE RESPONSIBILITY OF THE APPLIOANT TO AESUR( THAi <br />AL, L NECESSARY I~FORdATION HAS BEEN PROVIDED. <br /> <br />REMARKS: HARDSHIP AUTH <br /> <br />CITY JURISDICTION: BY ............ DATE <br /> <br />OFFICE COPY <br /> <br /> <br />