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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: 588-514.7 8:00 - 4:30 <br />24. HOUR CODE-A-PFtONE: §88~7904 <br /> <br />,,~JTUS ADO~EsI~LEIN. LARRY <br /> <br />9804 MiLL CREEK RO .SE <br /> <br /> TAX LOT: <br /> <br /> CONSTRUCTION TYPE: <br /> <br />MARION COUNTY <br /> <br />UGB: <br /> <br /> NO <br /> <br />FLO~3DPbAIN <br /> <br /> ~ONE: 749-2405 <br />: LOT:i BLOOK: <br /> <br />AREA: ~1 UNI'rSI <br /> <br />si'rE NUMBER: <br />RAN'~LALUAT ~ ON: <br /> <br />NO <br /> <br /> 5084 <br />ZONE; <br /> <br /> NO , <br /> <br />TYPE: ON-SI'rE SEWAGE <br /> <br />PERNI'f' OR APPLICATION NO: <br /> <br />CON'r R~C'FOR, NO. <br />KLEIN, LARRY <br /> <br />PHONE~ 749-2405 <br /> <br />25891 <br /> <br />WATER SUPPLY~ P~ <br />TEST HOLES READY: <br />SiTE EWALUA'f'ION NUNBER: <br />E~(Is'riN6 T/~K SIZE: <br />EXISTING BRAIN FIELD LIN~: <br />SEPTIC TANK PU~PBD: <br />PRE¥1t1JS NO. BEDRCOMS: <br /> <br />ITEM (i~J~l'll'Y AfcF,,XJNT <br />REPAIR - NiNOR 1 $55.00 <br /> <br /> TOTAL A~ED FE~ $55.00 <br /> PRE¥IOJS RECEIPTS $55.00 <br /> THIS RECEIPT $0.00 <br /> <br />BALANCE DUE $0+00 <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: CL 'tYPE: CHECK ~: 0 <br /> <br /> ~EE A'I"I'AOH6D BOCUNEN'f' FOR RE(~iRE~IE~'rS OF <br /> <br />~ST~CTi~ FAI~ TO~T ~:~I~ OF STATE <br />~ING O~IN~C~, THIS ~[T ~ALL B~ NU~D~ID. <br /> <br />RE.f~ARKS: TANK REPLACP2f~IPJ~'I' R~901 <br /> <br />DONALD E. I~OODLEY. IVlARION COUNTY BUILDING OFFICIAL / BY ....................................................................... <br /> <br />OFFICE COPY <br /> <br /> <br />