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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 />24 HOUR CODE-A-PHONE; 588-7904 <br /> <br />I ~m a registered builder OR ( ) the a uthorJzed tepre-sentetlve <br /> <br />AUMSV~LLE <br /> <br />OR 77125 <br /> <br />.... "fax iOY~ .... <br /> <br /> · RESII)ENT~L <br /> <br /> MARION OOUNTY: NO <br /> <br />2885 SW 224TH <br />HILLSBORO. OR 97123 <br />PHONE: 649-73~7 <br /> <br />' ~E~ION: <br /> <br />28 <br /> <br /> SITE NIJHBEE: 93-81748 <br /> VALUATIOI,h <br /> <br />1.5 AC NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />Plgl~MIT OR APPLZ~ATII3N <br /> <br />CONTRACTO~:~ NO, <br />LORE,~ DOU6 <br />2885'~W 224TH <br />HILLSBORO. OR <br />PHONE: <br /> <br />WATER SUPPLY <br />TEST HOLES <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: .... . <br />EXISTING ~RAIN FIELD LINES. <br />~EPTIC TANK <br />PREVIOU~ NO. BE~ROOHS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> EXIgTING SYSTEM EVAL. RF'T. t <br /> <br /> TOTAL ASSESSE~ FEES $~.~ <br /> THIS RECEIPT $I60.00 <br /> <br /> BALANCE DUE $0,,g0 <br /> <br /> P,AYEE: LORE, DOUG RECEIPT N~: 49~85 <br /> RECEIVED BY: cl TYPE: CJ( CHECK 8: 5t~0 <br /> ...................... ~~22~2~::~2~ .................... ~ ...................... <br /> SEE ATTACHED DOCUMENT'FOR REQUIREMENT~ OF ONISITE SEWAGE SYSTEM. <br /> <br /> $ THIS IS NOT A PERMIT. THIS APPLIEATIDN ~IJST ~ THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT t~ THE CESPONSIBILITY OF THE APF'LICANT '['g ASSUF~E THAT <br />ALL NECESSARY INFORMATION HAS BEEN <br /> <br />PL, AN REV~EW~ <br />REMARKS: ESE <br /> <br /> <br />