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MARION COUNTY BUILDING INSPECTION <br />SENATOR RLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM: OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4::30 PM - 8::00 A M <br /> <br />I 8m a registered btHIder O,, f J the authorized representatlwe <br />of a registered builder <br /> <br />I have read and 8g¢oo to t~o terms 8tared on the reverse side of 0AT6 <br /> <br /> DATE: 04/04/90 TIME: 10:01:5'7 <br />OWNER TAX LOT C'ATEG O R'~ <br /> <br /> GESCHER, BUD <br /> <br />RESIDENTI~ <br /> <br /> 11257 STEINKANP RD SE CONTR&CTCITY UGB <br />AUMSVILLE OR 97325 <br /> NtARION ODLINTY NO <br /> <br />USE Of BUILDING <br /> <br />OCCUPA*NT LOAD <br /> <br />MA~UNG AODRE55 SUBDWISION <br /> <br />3 <br /> <br />SAME <br /> <br />PHONE; 749-2096 <br /> <br /> 29 <br /> <br /> SITE NUMBER: 9803 <br /> VALUAT I ON: <br /> <br />8S 1W SA <br /> NO NO <br /> <br />MAP <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERIVlIT OR APPLICATION NO~ <br /> <br />CONTRACTOR. NO. 36786 <br />VALLEY SEPTIC SERVICE <br />PO 8OX 21088 <br />SALEM OR 97307 <br />PHONE: 393-4552 <br /> <br />902295? <br /> <br />WATER SUPPLY: P~ <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER~ <br />EXISTING TANK SIZE: 1000 <br />EXISTING DRAIN FIELD LINE~: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. 8EDROOMS~ <br /> <br />ITEM /'~ QUANTITY AMOUNT <br />REPAIR - MAJOR ~x- 1 $80.00 <br /> /~'~ TOTAL ASSESSED FEES $80.00 <br /> PREVIOt..IS RECEIPTS $0.00 <br /> ~ THIS RECEIPT <br /> $88.00 <br /> <br />BALANCE DUE $0~00 <br /> <br /> PAYEE: VALLEY SEPTIC SERVICE ~'~"-~'/- RECEIPT NO: 24329 <br /> RECEIVED BY: ~ F.':-. ;:=== TYPE~ OK ............... CHECK ~: 320 <br /> <br /> SEE ATTACHED 0OCUMENT FOR REQIUIREMENTS OF ON-SITE SENAGE SYSTIi~. <br /> <br />~ THIS IS NOT A PEri, IT. THIS APPLICATION I~.k.ST GO THROU(~H A REVIE~ PROCESS INHERE THE <br />FOLLOWING I~UST BE COMPLETED. IT ~S THE RESPONSIBILITY OF THE APPLICANT TO ASSURE 'THAT <br />¢NLI_ NECESSARY INFOi~TION HAS BEI~I P~IDED. <br /> <br /> PLAN REVIE~N: BY DATE...~iF/_.~f;~T~ CITY JURISDICTION, BY DATE <br /> RFj4ARKS: DRAINFIELD REPAIR R~¢0884 <br /> <br />FORN~,¢ Mc ,~e DE~ n,, OFF!CE COPY <br /> <br /> <br />