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MARION G~OUN~Y 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 />Iarn performing work or~ a roperty J own o occupy. <br />t am a registered builder O1~ ( ) the authorized representative <br />of a rogistered builder. <br />The work will be performed by a registered builder, <br />Other _ <br /> <br />HAL!...ivt&N, <br /> <br />8e3a DA,";d_E¥ R~ 3¢2 <br /> <br />MAILING ADDRESS: <br /> <br />DATE: <br /> <br /> ;;;'E'3 i ])T'IT f.a L.. <br /> <br /> CONF~TRUC¥10N TYPE: OCCOPANCY; <br /> <br />CONTRAO~ CITY: UGB: : oCCUPANT LOAD; <br />N~AR TON CQLI!,!T'Y NO <br /> <br />769~ "~ 5'-' 8 <br /> BLOCK: <br /> CEPTH: <br /> <br />XA T!...!Y !v!',:3G. <br /> <br /> ~S]" TE XLIIV!SER: !34.3'=` <br /> V.&LUAT ]~ ON .. <br /> <br />] S. COOO AC !,;0 <br /> <br />MAP: <br /> <br /> ; T L-Pt <br />,'~,, .... !', :, Z/~,? ~ QN NO .... F'LD. <br /> <br /> WATER 3LPPLY: Pb~ <br /> TE3T HOL. E3 READY: <br />901898", i SITE EV,&LUAT~ON NL.I~IEIER; <br /> EXISTING TANK Si'ZE: 303 <br /> <br /> SEPT;C TANK PLT~PEO~ <br /> ~ PREVIOLS NO 8EDROO~S 2 <br /> <br />RECE ;V~'() S'" <br /> <br />SE~T ,{','; TA:.'!:L : <br /> <br />* THTS 'rS NOT A PE~",lTT. <br />¢;OLLO~ING NUST 8E CONPLETC'D. <br />ALL. NECESSARY ;NFOR~',IA¥'rON <br /> <br /> '..,..N :,' ....." ¢~' E~'*/ -.., L,~-,, <br /> <br />;'*?4.&q!<[":}, ALI <br /> <br /> NO: <br /> <br />i <br /> <br />AIvIOLr',FT <br /> $ ! 05..33 <br /> <br /> $ !05_ <br /> $0. <br /> · ,~; 85.0:3 <br /> <br />$0, CC <br /> <br />PROCESS ~dERE THE <br />ICANT TO ~S~SURE THAT <br /> <br />REV M/88 OFFICE COPY <br /> <br /> <br />