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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 /> DATE: 09/09/92 TIHE: 16:02:00 <br /> <br />:'~TO*'~O'~ ............. <br /> <br /> AUMSVILLE OR 97325 <br /> <br />I am performing wosk on a ~roperty I Own Or occupy. <br />I am a regls{,~red builder OR { ) IHB authorized representmive <br /> <br />O~he~ ....... I ' <br /> <br />c~NT ZAL <br /> <br />505 W, RE~I~ ST <br />STAYTON OR 97~5 <br />PHONE: 769-2092 <br /> <br />OITTER HILLS ~2 <br /> <br /> VALUATION: <br /> <br />8 <br /> <br />TYPE: ON'SITE SEW~EE <br /> <br />PERHIT OR APPLICaTiON <br /> <br />CONTRACTOR, NO. 02145 <br />Eddie L Wilson <br />4077 State St <br />Salem, 97~01-5486 <br />PMONE~ ~99-i154 <br /> <br />~ 2 i 29 8~ . ~W ~R <br /> <br /> WRTE~ SUPPLY: PW <br /> TES~ HOLES RE~DY: YE~ <br /> 41505 S~TE EVALUATION <br /> EXISTING TANK SIZE: <br /> EXISTIN~ DRAIN FIELD <br /> SEPTIC T~NK PUHPED: <br /> PREVIOU~ NO. BEOROOMS: <br /> <br />48 <br /> <br /> ITEM QUANTITY AMOUNT <br />STANDARD ON-SITE SYSTEM .1 $210.00 <br />SITE EVALUATION, FIRST LOT i $2~0,00 <br /> <br /> TOTAL ASSESSED FEES <br /> PREVIOUS RECEIPT~ $4~0.00 <br /> THIS RECEIPT $0.00 <br /> <br /> .. BALANCE DUE <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVEO BY: CR ................. TYPE: CHECK ~ 0 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAEE SYSTEM. <br /> <br />NOTE: THIS DOES NOT ~RANT OR IMPLY P~RMISSION TO BUILO ON THIS PARCEL. PLANNING AND <br />ONSTRUCTIOM PERHITS MUST B~ OBTA1N~D BEFORE BUILDIN~ OR SEPTIC INSTALLATION BEGINS. <br /> <br />REMARKS: SE/ PERMIT - ~--/~/- <br />DONALD E. WOOOLEY, MARION COUNTY BUILDING OFFI:I~L / BY .................. <br /> <br />OFFICE COPY <br /> <br /> <br />