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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 228 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-8147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M, <br /> <br />t am performing work on a9roDerty I own o~ oQ~upy. <br />I am a registered builder OR ( )theauthOnzedrepresentBtwe <br />of a registered builder, <br />The work will be Cefformed by 8 registered builder, <br />Other~ <br /> <br />o~ 11/18/87 <br /> CHECK, L, JC~N <br />SITUS ADDRESS: <br /> <br />13213 BF~3OKSIDE DR <br />RORA' <br /> <br />CONSTRUCTION TYPE: i OCCUPANCY: <br /> <br /> I CONTRACT CITY: I UGB; i OCCUPANT LOAO: <br /> OR 9?002 <br />......................... ~R~ O~'" COU?~F'~' ' - '" i ' ' "NO ~ Mo 0~ ,E~00~S <br /> <br />SAME <br />tOT: BLOCK: <br /> <br /> ,~R:[ M 'EST~¥ES <br /> <br /> ~ SITE NUMBER.' 3032 <br /> <br />SECTION: TOWNSHIP ] I zON[: <br /> <br />AREA: ~ ;UNITS; :~ IRREG. LOT:~¢~ iCORNE~: E~ <br /> <br />TYPE:, ON-SITE SEWAGE <br /> <br />PERfc~IT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO- <br />CHECKAL, JOHN <br />SAME <br /> <br />PHONE~ 678-5414 <br /> <br />5405 <br /> <br />WATER ,SUPPLY: CW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: NO RECORD <br />EXISTING TANK SIZE: <br />EXISTING DP, AIN FIELD LINES: <br />SEPTIC T~NK PUMPED: FORM GIVEN <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ~TEfV. QUANT "TY AMOUNT <br />EXISTING SYSTEM EVAL. RPT. <br /> -¢ ,- F S <br /> ~OTAL Ao. SES'SED EE $60.00 <br /> · " PREVIOUS': REP-JEIPYS $80. <br /> 7f'R'¥S' ~ECE.I PT :' ¢0.00 <br /> <br /> ' ' <br /> <br /> ............ <br /> <br />Z~NG ORDZN~C~, <br /> <br />REMARKS: LOAN R~8120 REF~RT ~ <br /> <br />,~(,,,NA~© E. WOODLEY, mARION COUNTY BUILDING OFFICIAL / BY ......................... <br /> <br />fORM ,, MC 15-56 REV 8/87 OFFICE COPY <br /> <br /> <br />