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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: 588-5147 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />SITE I,EIHBEE: 73-B21}83 <br />VALUATION: <br /> <br /> )R~, LOT; ..l,. 5't .......... : <br /> I N~ ................................... -,,,~ .:,,, <br /> <br />TYPE= ON-S~TE SEWAGE <br /> <br />,ONT~ACTD~ NS. <br />JOH~BON~ EARL <br /> <br />PHONE: 74~-26~1 <br /> <br />?847798 <br /> <br />WATER SUPPLY <br />TEST HOLES REABY; <br />SIT~ EVALUATION NUHBE~: <br />EXISTING TANK SIZE: <br />~XISTING DRAIN FIELD LINES: <br />~PTI~ TANK PUMPED: <br />P~EVIO~s NO. BEDROOMS: <br /> <br /> ITEM OUANT I TY AMOUNT <br /> ANNUAL EVAL~ - TE~P OR HDSHP MW 1 $9~.0B <br /> <br /> TOTAL ASSESSED FEES $70.88 <br /> · PRE¥'iOU$ RECEIPTS $0.80 <br /> <br /> PAYEE: PLANNZNG DEDT ~RANS, EgE <br /> S~E ATTACHED D~CU~ENT' FOR, REQUIREMENTS' OF 'ON-~ITE ~EWAGE SYSTEM. <br />):GLLO~Ji~,~ EUST ~E COMP_E ED. IT IS THE RERPO~S , E PROCESS ~EE THE <br /> w~ ,~.mv · ,~:,;~.~ F,.~ ~. ......... ~,~ · I~ILITY OF THE ~PPLICANT TO A~U~[ THAT <br /> <br />~o~, ~ ~,~ nEY. ~ OFFICE COPY <br /> <br /> <br />