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MARION COUNTY BUILDING INSPECTION <br />.~ENATOR BLDG. NO. 2:85 <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 /> Olher, <br /> <br />~OWN~ ~ RFSIDENTIAL <br /> BISSELL,¢ ANMETTE ~ 74442-~7t ~ - , <br /> <br /> 6521 SAMTIAM SPRINGS CT BE'~¢~6~-c~ ~u~s~ occu~N~ cO~O: ~ <br /> AUMSVILLE OR 97~25 ~ MARION COUflT~ NO ~ <br /> <br />4898 - 71ST AVE SE <br />SALEM 97201 <br />PI"lONE= 362-361~ <br /> <br />sAMZ$3[ s_ B! ..................................... <br /> SITE (41J~J~ER: <br /> VALUATION: <br /> <br />i .... 8 L ......... ~l i 8L ........ ~ ............ [ --~R .......... L_,,,,Ei ........ <br />, I 2.2i . ,AD YES ! NO , <br /> <br />TYPE: ON-SITE SEWAOE <br /> <br />PER~IT ~R ~PPLICATIO~ <br /> <br />CONTRACTOR~ NO~ <br />BISSELL. AI~NETTE <br />4890 - 71ST AVE SE <br />SALEM 973~1 <br /> <br />4879& <br /> <br />WATER SUPPLY: PW <br />TEST HOLEB READY~ YES <br />SITE EYALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTIN~ DRAIN FIELD LINES: <br />SEPTIC TANK PUHPED: <br /> <br /> ITEH ~UANTI'FY AMOUNT <br />~ITE EVALUATION~ F~RST LOT 1. $265~80 <br /> TOTAL'.,.~B$£SSE~: ~EES $265.00 <br /> $255,88 <br /> PR'E¥IOUS;'~ECEIPT$ <br /> TH'I;~,.EECE~P~;'' · $0~00 <br /> <br />PAYEE: ':"~:"-', RECEIPT N~: <br />RECEIVED BY: CL_ .............. ~.- . = .......... ._~_~ TYPE: CHECK ~: 0 <br /> <br />SEE ATTACHED DOCUMENT FOR REQU~RE~ENTS/OF",.'O~E"~EWAGE"SYSTEHo <br /> <br />NOTE= THIS 80ES NOT G~AN'T'.O~ t~F'E~. PERMiSSiON. TO..BU.tE.D ON THIS PARCEL. PLANNING AND <br />ONSTRUCT~ON PERMITS M~T..BE OBTAINED.BEFORE..BUILDIN~ :OR"SEPTIC INSTALLATION BEGINS. <br /> <br />RLMARKS., SE - S'fD SYSTEM NEEDS STAKEOUT LAYOUT' .. : <br />DONALD E~ WOODLEY~ MAR'ION COUMTY BU'I'LDIN~ OFF¥CIA~ / BY"' _ .............................................................. ._~ <br /> <br />OFFICECOPY <br /> <br /> <br />