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MARION COUNTY BUILDING INSPECTION <br />SENATO. R BLDG. NO, 225 <br />220 HIC~H 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 />OAT'E: l'i/04/92 <br /> <br />GUSTAF$ON, CARL <br /> <br /> 135 SECOND ST <br />DETROIT <br /> <br />,'¢"'/L,¢ <br /> <br />DATE: .............. <br /> <br />TIHE; L0:46:17 <br /> <br /> 90250-~25 ,. RESIDENTIAL <br /> <br /> ~ATTON <br /> <br /> SITE NUHBER: <br /> PHONE: VALUATION: <br /> <br />2 4 : Z &O , 5E .i RS LO5 <br /> NO NO <br /> <br /> TYPE: ON-$]TE SE~6£ ~ATER SUPPLY: <br /> TEST MOLES READY': <br /> PERHIT OR APPLICATION NO: 904~65~ SITE EVALUATION NUHBER: <br /> EXISTING TAHK SI[E: <br /> CONTRACTOR, NO EXISTING ORAIN FIELO LINES: <br /> GUSTAFSON,'CARL ~EPTIC TARE PUMPED: <br /> PREVIOUS NO~ ~EOROOHS: <br /> PHONE: <br /> <br /> ITEM QUANTITY AMOUNT <br />SITE EVALUATION, FIRST LOT i $220.00 <br /> TOTAL ASSESSED FE~$ $220.00 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS'RECEIPT $220.00 <br /> 8A~NOE DUE <br />PAYEE: GUSTAFSON, CARL , INVOICE NO: 457~8 <br />RECEIVED BY: gL ................................. TYPE: IN CHECK ~: 0 <br />SEE ATTAONEO OOCUMENT FOR REQUIRENERTS OF ON-SITE SEWAGE.SYSTEM. <br /> <br />NOTE: THIS OOES NOT GRANT OR IMPLY PERMISSION TO BUILD ON ' ; ,, . · <br />¢'LAN REVIEW: 8 '/Z-_OATE Z /C_Z C TV URIS OTION- OAT <br /> <br />rO~M ~ MC ~s-so ~Ev, ~ OFFICE COPY <br /> <br /> <br />