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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 /> of a registered builder. <br /> <br /> Other <br /> <br /> DATE: 0g/30/87 TINE~ 4;16;42p <br /> <br />OWNCC; NAOSWORTH, SCOTT <br /> <br />SIYUS AOCRESS; <br /> <br /> ?767 ALSUS RD <br />AUMSVILLE <br /> <br />MAILING ADDRESS: <br /> <br />SIGNATURE OF APP~ICANT: <br /> DATE'. <br /> <br /> i TAX LOT: iOATEGORY: COMMERiCAL ,:;i <br /> .... '~ ~O"STRUCTIO" TYPE; : OCCUPANCY: <br /> <br /> SE <br />OR 9?325 i CONTRACT CITY: i CGS: iOCCLJPANT LOAD: <br /> MAR~ON ~NTY ~ NO <br /> <br />SANE <br /> <br />PHONE: 749-2419 <br /> <br />LOT: CLOCK: <br /> <br />WIDTH: <br /> <br /> SITE NUMBER: 2510 <br /> VALUATION: <br /> <br /> 30 8S ; lW ~ SA 48 <br />:AREA, 1 .00000 ?NITS: AC ~ iRCEG, LOT: NO ic°Bf~ <br /> <br />I~¢'PE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONTRACTOR. NO. <br />wADSWORTH. SCOTT <br />SANE <br /> <br />PHONE: 749-2419 <br /> <br />4339 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED; 9-14-87 <br />PREVIOUS NO. BEDROOIv~5: <br /> <br /> ITEM QUANT I TY AMOUNT <br />AUTHORIZATION NOTICE w FLD+ VISIT 1 $65.00 <br /> <br /> : : TOT.~L A,S,SESSED :FEES $65.00 <br /> : ',:PRE~IOUS' ~ECEIPTS $65.00 <br /> , ] TB I S: RECE I PT $ O. 00 <br /> ,' DANCE ~E $0,,00 <br /> <br />PAYEE ~ , ' :~ ,, , ~EcEI PT NO: <br />RECEIVED BY: ~ ': %YBE~ ~ECK ~: <br /> <br />REIVLARKS: AUTH.NOTICE -FLD VISIT <br /> <br />DONALD E. WOODLEY, MARION COUNTY BUILDING OP?ICIAL / BY <br /> <br />¢O~M ' MC; ~r,-~ R~V ~/e? OFFICE COPY <br /> <br /> <br />