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MARION COUNTY BUILDING INSPECTION <br /> SENATOR OLDG NO 225 <br /> ~. 220 HIGH STREET NE <br /> ~ SALEM. OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-P44ONE'~::30 PM - 800 AM ~' <br /> <br /> lam perform,rig work 0n ~ property I 0wn or occupy --~ ~.~ <br /> <br /> PETE~. THEO~RE RESIDF~TIAE~ <br />S~TUS ~DOn~SS CO,St~UCT,O~ TW¢ OCCU¢~CV <br /> <br /> 9117 SILVER FALLS HWY <br /> AUMSV I LLE <br /> <br />LJ~E O¢ BUIL01NG <br /> <br /> SA~E <br /> <br /> PHONE: 362-1555 <br /> <br /> SE CONTRACT CII'Y UG8 OCCUPANT [.,OA0 <br />OR 9?325 <br /> ~^~,-~ION CZTJNTY NO No o¢ I~EDDOOMS <br /> <br /> NO <br /> <br />7188 <br /> <br />NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PEI;~IlT OR APPLICATION NO: 9015740 <br /> <br />CONTRACTOR, NO. <br />PETERS, THEODORE <br />SAME <br /> <br />PHONE: 362-1555 <br /> <br />~NL~TERSUPPLY: P~ <br />TEST HOLE~ READY= <br />SITE EVALUATION Nur48ER; <br />EXISTING TANK SIZE: 900 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: NILL BRING IN <br />PREVIOUS NO. 8EDROOM$: 3 <br /> <br /> ITEM QUANT I TY AIVlOUN T <br />AUTHORIZATION NOTICE - FLD, VISIT: ~ 1 $105.00 <br /> · ~ _. _-~-~ TOTAL ~SE~ED FEES $105.00 <br /> <br />PAYEE: GRISWOLD, ~RY P. ~ ~~--& O~ ~t, RECEIPT NO: 16732 <br />RECEIVED 8Y-~ Ch ~~~~ ''~-~PE- OK ~ECK ~-2 128 <br /> <br />SEE ATTACHED ~T FOR RE~}~TS~~T~'OF ~-S[TE S~GE ~T~. <br />~ ~IS [$ NOT A P~[T. ~[S',A~[~T[~ ~T .~ ~ A R~[~ P~ ~E~ ~E <br />ALL N~ IN~TI~ H~ BE~ P~ZDED. ~=' <br /> <br />PLAN REVISN: 8Y .......... DATE <br /> <br />REIVL~RKS: ~ HDSHP AUTH R~7025 <br /> <br />CITY JURISDICTION: SY ....... BATE .......... <br /> <br />OFF.ICE COPY <br /> <br /> <br />