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MARION COUNTY BUILDING INSPECTION <br />SENATOR SLOG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-$147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />5125 AUBURN ~D NE <br />PHONE: 363-~77,~ <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERHIT OR APPLICAT!BN <br /> <br />CONTRACTOR, NO. <br />H~SER. RONAL~ <br />5~25 AUBURN RD NE <br />SALEM <br />PHONE: <br /> <br />4t~00. ~ SF <br />?~47705~ <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY:, <br />SITE EVALUATION NUMBER~ 81-~54 <br />EXISTING TANK SIZE~ <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUs NO. BEDROOMS: <br /> <br /> ITEM <br /> QUANTITY AMOUNT <br /> STANDARD ON-SITE SYSTEM 1 $255.08 <br /> · TOTAL ASSESSED FEES $255.00 <br /> PRE~IOUS RECEIPTS $0.0~ <br /> ' TNIS ,RECEIPT' <br /> <br /> PAYEE: PUDDDIN~ RIVER BLDG ZNC '""'"':,'..".' . . R~CEIFT NS: 47~93 <br /> RECEIVED BY: CL ....... ; ............ .. .~.:~... .... _- TYPE: CK OHECK ~: 1071 <br /> .... ~ ..... ~I Iii~ ~l~i~ ~ ....... ~ ..... ~ ...... ~ ~ II~tiii i ....... ~ ..... ~ ........~ ~ ,~ ....~ ...... <br /> SEE ATTACHED DOCUMENT'FOR REqUIREMENTS'OF ON-SITE SEWAGE ~YSTEM, <br /> <br />^,,-~A~g~B-.RE_~HOr~'-D. IT'IS THE R~PONSJ:B~I~ITY OF THF ~PPFYP~WT 'rn <br /> <br />PLAN R~VIEW: <br />RE~ARI(S: STD <br /> <br />OFFICE COPY <br /> <br /> <br />