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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:;30 P.M. - 8:00 A,M, <br /> <br /> I am performing work on e property I owr~ o¢ occupy, <br /> I am a registered builder OR ) the authorized representative <br /> of a registered builder. <br /> The work wilt be performed by a registered builder. <br /> Other .... <br /> I have resd and agree to the terms stated on the reverse side of <br /> this document. <br />gATE'- 05/'13/88 TIME; 8:29:30e <br /> <br />owr~En; GUNTHER, CHARLES IITAXL~: 40080~000 CATEGORY: RESIDENTIAL <br /> <br /> i CONSTRUC'C~ON 'fYPE'. <br />S~ruS AOO~SS; : occ~N~: <br /> <br /> 11823 A~DT NE : <br /> ~.~ OR 9?002 ~6O6U~ANT <br /> <br />US6 OF BUILDiN~: ~ ~N0 0¢ BEDROOMS: <br /> 3 <br /> <br />~A}LING ADD~ESS: <br /> <br /> SA~E <br /> <br /> PHONE: 678-1515 <br /> <br />LO'(: <br /> <br />BLOCK: <br /> <br /> I SITE NUNBER .* 2102 <br /> ~ VALUAT ION: <br /> <br />i SECTION: , 3S i <br /> 33 i lW ', EFU <br /> <br />TYPEt ON-SITE SEWAGE <br /> <br />9008466 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING BRA~N F~ELD LINES: <br />SEPTIC TANK PU~PED: <br />PREVIOUS NO. BEDROONS; 3 <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />OONTRAOTOR, NO. <br />GUNTHER, CHARLES <br />SAr4E <br /> <br />PHONE: 678-1515 <br /> <br />...........................ITER ~"t> .............................................. QUANTITY At4OU <br />ALTERATION ~f%/o~ , , . I $145.00 <br /> · ~ ~OTAL ~ESS~D'FEES $145.00 <br /> ~ PREV'~OUS".RECEIPTS $0.00 <br /> TH~S,RECEZPT $145.00 <br /> <br /> 8AL..~'~CE DUE $0_00 <br /> <br />PAYEE: ~NTHER, ~ARL~ BECEZP~ NO: 9122 <br />RECEIVED BY: CL .................... ~PB: OK CHECK ~= 1531 <br /> <br />SEE ATTA~ED ~UNENT FOR BE~R~TS OF 'ON=~2%E S~E <br /> <br />· ~S Z~ NOT A PE~ZT. ~S AP~Z~T~ ~T ~"~ A ~ P~ ~E~E ~E <br />POL~]N6 ~ST BE ~PLbI~O. ~T. ~ ~E,,,R~SZB~L%~ OF ~E ,A~L~ TO ~RE ~AT <br />ALL NEC~ ~NFO~T~ ~ BE~ ~DED,., <br /> <br />~ENARKS: ALTERATI~ PE~IT FOR D~ZNFEZLB <br /> <br />"O"M ~ MC ~,',.~e *~v e/s: OFFICE COPY <br /> <br /> <br />