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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 RM. - 8:00 A.M <br /> <br />ow~TE: 06/19/89 TtME~* 1:21:50p <br />tuTUS ADDRESSGALLO~b~Y' KENT ) <br /> <br />AU SVILLE O* <br />USE OF BUILDING: % ~ ~ <br />MAILtNG ~DDR~SS; ~ ~ <br /> <br /> ~E: 749-1899 <br /> <br /> TAX LOT: CA/'EGOHY: <br /> F~ESI BENT [ AL <br /> <br />~RION COUNTY NO NO <br /> <br />SITE NUMBER.* 2099 <br />R~:~YALUATION: ZON[: <br /> <br />MAP: <br /> <br />WIDTH: DEPTH: AREA'. O6 UNITS; ~ IRREG LOT: 1~1 CORNER: 60 <br /> <br />2~00000 AC 'NO NO <br /> <br />TYPEs ON-~ITE ~ENAGE <br /> <br />PEF;~IT OR APPLICATION NO: <br /> <br />CONTP. ACTOR. :NO. <br />GALLONAY, KENT <br /> <br />PHONE: 749-1899 <br /> <br />9016940 <br /> <br />MATER SUPPLY= PH <br />TEST HOLE~'READY= <br />SITE EVALUATION NUM~ER: <br />EXIST~NG,~ANK SIZE= <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOJS NO. BEDROOf¢~: <br /> <br />ITEM ~!tJANTITY Ar4OUNT <br />REPAIR - MAJOR 1 $80.00 <br /> <br />PAYEE: ~¢,LL~Y. KENT <br /> <br />fl~olFAL ASSESSED FEES <br />THfS RECEIPT <br /> <br />$80.00 <br /> $o.oo <br />$80.00 <br /> <br />BALANCE BUE $0.00 <br /> <br /> ,','RECE[PT NO: 17907 <br />RECEIVED BY: ON ,TYPE=,',CA CHECK ~= 0 <br />SEE ATTACHED DOCUMENT <br /> <br />* ~[T.__ ~ ~ ~E <br /> TO .~ ~T <br />ALL~ IN~TI~{ <br /> <br />PLA~ <br /> <br />CITY JURISDICTION: BY <br /> <br />DATE <br /> <br />FORM ~ ~C 15.56 R~V H/SE OFFICE COPY <br /> <br /> <br />