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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 226 <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 /> Other <br /> I have read 8nd agree to the refT'ns stated on the reverse slde of <br /> <br />DATE: 03/30/88 TIME: 2:40:41p <br /> REACH, MERLE <br /> <br /> 86?3 WEST STAYTON RD <br />AUMSVILLE OR 9?925 <br /> <br />SA~4E <br /> <br />PHONE: 749-265? <br /> <br /> i CO~¥~ION TYPE: : OCCUPANCY: <br />SE ! CONTRACT CITY; i COB; iOCCUPANT LOAO; <br /> MARION COUNTY <br /> <br /> SITE NUIvEER: 4028 <br /> ; VALUATION; <br /> <br /> RANGE; <br />36 8S 2W ! EFU <br /> <br />MATER SUPPLY; PW <br />TF_c..ST HOL~ READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOFG: <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PECC4IT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />BEACH, MERLE <br />SAME <br /> <br />PHONE: ?49-265? <br /> <br />9007547 <br /> <br />iN0 OF ~DR00M$ <br /> <br /> 2 <br /> <br />REPAIR , t' )., 1 $35.00 <br /> <br /> f"'/\ TOTAL ,4~:~ES,SED FEES $35.00 <br /> ~ PRb-VIOUS 'RECEIPTS $0.00 <br /> THIS RECE[PT $35.00 <br /> <br /> 8AL:ANCE DUE $0.09 <br />PAYEE: BEACH, MERLE ~,¢~~-''''~ RECE];PT NO: 81 8 <br /> <br />SEE ATTACHED ~T FOR S~ <br /> <br />FOLL~IN~ ~ST BE ~PL~EB. IT IS ~E ' R~IBIL~ OF ~E :APPLIQ~T TO ~RE ~T <br /> <br />P~N R~IEN: 8Y ..... DATE~.~___ CITY JURISDICTION: BY DATE <br />REJ~ARKS: REPAIR R~9523 ~ <br /> <br /> <br />