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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 /> am 8 registered builder OR { ) the authorized representative <br />) Other. <br /> <br />OWNER; SHANNON- EMPLOYEE DYKE, GREG <br /> <br />' TAX LOf: ; CATEGORY; <br /> <br />12113 ARNDT RD NE <br />~OR,~ CR 99002 : Ud~B: OCCUPANT LOAD: <br /> ~4C: N <br /> <br />21356 HUBBARD CUT OFF ~48 - DYKE <br />AURORA OR 9?002 <br />PHONE;= 578-1855 <br /> <br />SITE NUMBER: <br /> VALUAT ;~ ON; <br /> <br />1738 <br /> <br /> i RANGE; 1N zONE: MAP: <br />3S , <br /> <br />WIDTH: DEPTH: AREAl ! 0O - 00~g~4iT~i AC IRIREG LOT; ~:' CORNER: ~ <br /> <br /> ~Y]~: UN-Si i~= SEWAGE I WATEi~ ~PPEY: <br /> : TEST HOLES READY; <br /> PERMIT OR APPLICATION NO= 90028~8 A~ SiTE EVALUATION NUNBER: <br /> EXISTING TANK SIZE= <br /> CONTRACTOR~ <br /> NO. ~'~ EX~STING DRAIN FIELD LINES: <br /> ~tANN~., EMPLOYEm c DYKE, GREG ~% I SEPTIC TANK PUMPED: 1-25--.87 <br /> ;2:358 HUBSAR0.CUT OFF ~48 -- ~% PREVIOUS NO. <br /> AURORA OR 9 ¢002 '[) <br /> PHONE; 578-., f 655 <br /> <br /> ITE~ OUANTI ~ , A~OUN-7 <br /> AUTHORIZATION NOTI,.c - FLD. VISIT <br /> <br /> PREVIOUS RECEIPTS <br /> ~IS RECEIPT <br /> <br /> BAL~CE DUE $0.~¢'".., <br /> <br /> PA~E~: SHANNON. EMPLOYEE DYKE, GR~ INVOICE NO~ 3485 <br /> TY~E: C~ CHECK ~: 2532 <br /> .................................................. <br /> SEE ~TTACHED ~U~ENT FOR REQU~RE~EN SYSTE~- <br /> <br /> ~ ~IS IS NOT A PE~IT. ~IS A R~I~ P~ ~ERE <br /> FOLL~ZNG ~ST BE ~PL~ED+ <br /> ALL NEC~RY <br /> <br />PI._~ REVIEN: SY BY <br />REMARKS~ i'~ <br /> <br />DATE ................ <br /> <br /> <br />