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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: 588~147 S:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> DA~.. 0.6/.~8/t;'.;~ ....... ~T,..,E~ .... .8: ~,8,,,j~,~. ................. ~"f..:'~'"Co'~- ................................... ~"-~'Y¥~.'6~- ....... <br /> <br />................................................... SITUS ^DORECS: i~-ci'~ ~ ~-U ~fi <~ ~ ' ~';¢'¢' ~ ~ .................. }"~l~(:g'~,',~ A~'~ i ....... <br /> [ <br /> ~08 SANTIAM AV FOowT~C~ C~Y~ , <br /> ~ETROIT ~ ~734~ ] ~gTRO~T ; NO <br /> ~ ! <br /> <br /> ......... ..~,~.~ ....................... a ... <br /> ............................................ ' ..... <br /> <br /> ~ HAMMOND ADDN , <br /> $~1 ~EERiNG AV NW <br /> SAL, EM~ OR 9'7~4 SITE NUMBER: <br /> PHONE: ~4,-1~:L7 VALUATION: <br /> <br />'~o~ ................ ~'~E~ A,. ............ ~,ON: .......... .'fO~ .... ~A'~7 .............. ~ Z dA-~ ........... ;'~ ............ <br /> : , , . .~ . ~ ~ <br /> 55 lae~ 880~. ~ NO ~ NO , <br /> <br />TYPE= ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONTRA£TOR~ NO. <br />STR~NGER. SIM & HANNELORE <br />38~1 3EER~NG AY NW <br />SALEfl~ OR ~7904 <br />PNONE. 3&4-1817 <br /> <br />WATER SUPPLY: CW <br />TEST HOLES READY: <br /> <br />E×IST~NG DEA~N FIELD LINES: <br />SEPTIC TANK PUNP~: 8-18'-'~2 <br /> <br /> ITEM QUANTITY AMOUNT <br /> AU'TNORIZATION NOT.L,,E eLD. VISIT 1 $16~. 0~ <br /> TOTAL A'~SESS~ FEE~ $!68,88 <br /> PREVI,OU~ RECEIPTS $0.00 <br /> , THIS REGEIPT $i~0.00 <br /> <br /> 'BALANCE,DUE $8.08 <br /> <br /> PAYEE: 14m"veZ R&chards ,', II,IVO~;CE ~0~ 49834 <br /> RECgtVED BY:: ~'B ........................................... 'fYPE; IN CHECK ~: 0 <br /> SEE AT fAG ~ED DOCUMENT F'OR REQIJIREM£NTS OF ON-SITE SEWACE S¥STEN. <br /> * THIS I~ NOT A ~ERHIT. THIS APPLICATIB~ flUST GO THROUGH R REVIEW PROCESS WHERE THE <br />FGLLOW%NG MUST BE COMPLETED. IT ~ THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY ~NFORNATION HAS BEEN PROVIDED. <br /> <br /> <br />