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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> 75050-050 <br />CONSTRUCTION TYPE OCCUPANCY: <br /> <br />'I821 'f'ERRANCE LN SE CONTRACT CITY UG8 OCCUPANt LOAD <br /> <br />0.88 AC NO NO <br /> <br />AN 5 'I ~ <br /> <br />TYPE: ON-SI'f'E SEWAGE <br /> <br />PERf41'|' OR APPLICATION NO: <br /> <br />CON'TRACTOR, NO+ <br />~'FiERREZ, JO~E & BEATRICE <br />SAME <br /> <br />PHONE: 749-3122 <br /> <br />9032446 <br /> <br />WATER SUPPLY: <br />'rEST HOLE.S READY: <br />SiTE EVALUATION NUfeBER: <br />E~i3'FINO T~qK 3iZg: <br />6~S'I'ING DRAIN FIELD LINES: <br />~Ep'ric TANK PUNPEO: <br />PREVIOU~ NO. BEDROOMS: <br /> <br /> EXiS'f~NG SY$'f'E~ EVAL. RPT. ~,/ 1 <br /> TOTAL ~ESS'EDFEES <br /> PREVlE~JSRECEIP'FS $0-00 <br /> ~/ 'I'HIS RECE:iPT $100.00 <br /> SAUCE ~E $o.0o <br /> <br /> PA~E; ~AYN'f~, ~'['HE~ZNE RECEIPT <br /> R~CEtVEO BYt c'l 'f'~E= CK CHECK ~ 1128 <br /> .......................................... ~ ._ ~ .~ _ _ ._ ~,._ ,.. <br /> <br /> ~EE Af"f'AC~ED ~'f' FOR RE~R~f~ 0¢ ~-s~'rE,~BNAGE SYs'r~. <br />~ fHJS ]8 NOT A PE~T. ~HJ~ APDLt~T~ ~ET ~ TH~ A R~ P~ ~ERE THE <br />~LL~N6 ~8~ 8E ~PLETED. J~;~ THE R~BJL~TY O~ THE APPL~C~T TO <br />ALL N~ IN~Ti~ BE~ P~ViDED+ <br /> <br />~. ~v,~: .~ ............. ~ ........ ~_.~.:~..~L ...... c,~ .~.,~-.~: .~ ............................... o~t~ ............................ <br /> REfflARKS; NEN SYSI'E~ 3/88 / LO~ RE~RT <br /> <br /> OFFICE COPY <br />FORM # MO 15-56 R~. 4/90 <br /> <br /> <br />