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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 a registered builder OR ( ) the authorized representative <br /> <br /> The work will be Der¢ormed by a registered builder. <br /> Other_ <br /> <br /> DATE; 09/14/87 TIME: 3:45;32p <br />'OWNER; WADSWORTH. SCOTT <br /> <br /> SITUS ADDRESS; CONBTRUCTION TYPE: <br /> <br />CATEGORY: RESIDENTIAL <br /> <br /> 7767 ALBUS RD SE <br /> AUNSVILLE <br /> OR <br /> 9?325 <br /> I~RION COUNTY NO <br />UsE O~ ~I/O~N~: ~ <br /> :N0 OF BEDROOMS: <br /> <br /> 2 <br /> i SUBDIVISION: <br /> <br />~tTE NUI~3ER; 2510 <br />VALUATION: <br /> <br />ISECTION: ~ TOWNSHIP; , RANGE; ZONE: MAP: <br /> 8s i 1w ! SA, 48 <br /> <br />PHONE: 749-2419 <br /> <br />LO1: :BLOCK; <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONTRACTOR, NO. <br /> <br />SAME <br /> <br />PHONE.+ 749-2419 <br /> <br />WATER SUPPLY ~ <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE= <br />EXISTING DRAIN FIELD LINE$~ <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO~ BEDROOMS: <br /> <br /> 9004333 <br /> <br /> I, TEN qUANTITY AJvlOUNT <br />AUTHORIT.~T[ON NOTICE - FLD. VISIT q $65.00 <br /> <br /> TOTAL ~E~ED FE~ $65.00 <br /> PR~[~- RECEI P~ $0 ~ 00 <br /> ~IS RECEIPT $65.00 <br /> <br /> BA~CE ~E $0.00 <br />PAYEE,~R~.~TT ~ RECEIPT NO, 4899 <br />RECEIVED BY: pb ~ ~PE: OK ~ECK ~: 119' <br /> <br />SEE ATT~ED ~M~T FOR REVISITS OF ~ITE' 8~E S~T~. <br /> <br />P~ R~[~: BY _~_ mTE_~~-- CZW JU:R~SD~CTZm~ BY ........ DATE <br />r~r~: <br /> <br />CORM '¢ MO 15'56 REV 6787 OFFICE COPY <br /> <br /> <br />