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MARION COUNTY BUILDING iNSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET N6 <br /> SALEM, OREGON 97301 <br /> <br /> PHONE:588-5147 8:00-4:30 <br />24 HOUR CODE-A-PHONE: 688-7904 <br /> <br />GUSTAFSON, C~RL ' 90250-~25 ~ RESIDENTIAL <br /> <br /> ...... ...................................... <br /> ~TE NUHBER: 92-05895 <br /> PHONE: VALUATION: <br /> <br /> gO lO0 , 9oo0. · ~F ~ NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATIOH ~0: <br /> <br />CONTRACTOR, NO. <br />GUSTAFSON, CARL <br /> <br />PHONE: <br /> <br />43&53 <br /> <br />WATER SUPPLY: <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING ORAIM ¢iELO LINEB: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM <br />SITE EVALUATION, FIRST LOT. <br /> <br />QUANTITY .AMOUNT <br /> i $220.00 <br /> <br />TOTAL ASSESSED PEES $220_00 <br />PREVIOUS RECEIPTS $220.00 <br />.. THIS RECEIPT $0.00 <br /> <br /> '~A'CANCE DUE $o.oo <br /> <br />PAYEE: INVOICE NO: <br /> TYPE: CHECK <br /> <br />RECEIVED BY: PB ............................. 0 <br />SEE ATTAOHEO DOCUMENT FOR REQUIREMENTS'OF ON-SITE BBb/ABE SYSTEM. <br /> <br />NOTE: THIS DOES NOT GRANT OR.~MPLY PERMISSION'TO BUILDON THIS PARCEL. PLANNING ANO <br />ONSTRUOTION PERMITS MUST BE OBTAINED BEFORE BUILDING OR SEPTI6 INSTALLATION BEGINS. <br /> <br />REMARKS: SE - OKAY BOR A TWO 8EDROOH HAXIMUH REBIOENCE~STD SYSTEM /~ <br />DONALD E. WOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY .......... ~ .......................... <br /> <br />¢gRM 8 MC 15-56 R~V, 4/~0 OB~IOE COPY <br /> <br /> <br />