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MARION COUNTY BUILDING INSPECTION, <br /> SENATOR BLDG. NO. 225 ~ i L ~ <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 58S-5147 8:0~- 4:3G ~"} <br /> 24 HOUR CODE-A-PHONE; 5~-7904 ~ / / · / <br /> <br /> DATE= ~81~9/9~ T~M~: <br />~Ow~,: KA~L,E.Y~' JOHN M. <br /> <br /> AUMSVILLE OR 97325 ~-~~'~'~ ............. ~6>~h~- L&~O~ .............. <br /> <br /> PHONE: ~45-&222 VALUATION: , <br /> <br />; ' ...... ............ ........................... <br />W~B:~: ....... :'6~'~: ..................... ~ ~: ............ <br /> ', <br /> <br />TYP~= OH-SITE SFJJAGE <br />PERHIT OR APPLICATION NO: ?B48~72 <br /> <br />~ONTRACTOR. NO. <br />KAILEY~ JOHN M. <br /> <br />PHONE: 945-6222 <br /> <br />WATER SUPBLY: PW <br />TEST HOLES READY: <br />$~TE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1808 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: 3 <br /> <br />225 <br /> <br /> ITEM ..... QUANT ITY AMOUNT <br /> EXISTING SYSTEM EVQL.,, RF'~..?:,. ,: ....... 1 $160, <br /> · "" 'TO'TAL: :.hS'~J£S~ED 'FEES $'t 60:00 <br /> <br /> · ..:,":.",. ',: "'"E ' ' " $~ <br /> .... "'" :'- B~L~wC ..DUE,-'" ' <br /> PAYEE: KAILEY, J~N Hi~'"..".":'-:'.".' '.:,, ,',; ....~'J .' '.: ","' :.. RECEIPT NO: 51385 <br /> R~CEIVED BY. M~ ~ ............. :,,,.:. ..... TYFE. CE CHECK ~. 2 <br /> ............... : ~ :~=:~:~%~;~::::=%:~_ ~ ....................................... <br /> SEE ATTACHED BOCUMENT'=FOR"~REQO~E~EN~_~,,OE~,,DN~.~'I~.:.;SE~A~E SYSTEM. <br /> ~ THIS IS HOT A PER~IT.'".'THIS"~PPk~T~ '~,'*~"'~H A REVIE~ PROCESS BHEEE ~H <br />FOLLOW?~ HU~T BE CO~FLETED,:: IT i'~'THEi~ESffONSIBILITY OF ,THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORHATI,ON' HA~ BEEN PROVIDEB~ ,'' ' .- :" <br /> <br /> ' ' .... ' <br /> CITY JURISDICTION: BY BATE <br /> PLAN REVIEW. BY ............. .,7 <br /> REMARKS: S~:ESE WILL BRI;4~ IN AS$O~ ~tAP' AN~ PUHPE'R FORM <br /> <br />poP~ # ~c ~,~v..w OFFICE COPY <br /> <br /> <br />