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MARION COUNTY BUILDING INSPECTION <br />SENATOR BL,~DG, N~), 225 <br />220 HiGH ~.T~E:E~ NE <br /> SALEM, OR~-GON 97301 <br /> <br /> PHONE; 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I 8Pl performinu work on a property I own or occupy, <br />I am a ¢eC~stered builder O¢4 } the authorized representative <br /> <br /> KOTI'RE, RA'~X, <br /> <br />SIGNATURE OF APPUCANT: ~ A <br /> <br /> , TAX LOT; CATEGORY: <br /> CONSTRUCTION TYPE: OOCUPANCY. <br /> <br /> 8612 SHAN S()LIARE ' R SE , O0~TRAcT CITY: , UaB: O00UPANT LOAD: <br /> AUIN~V 1LLE ~SN(~' \ 9?325 I'4A R.~ ON NO <br />USE OF iBUILDING: <br /> <br />8613 SHAW SQUARE R,B. SE <br />AUI'4~VlLLE, OR 97325 <br />PHONE: 38;4-2318 <br /> <br />10216 <br /> <br />AREA: <br /> 6.039~9996 <br /> <br />RESIDENTIAL. <br /> <br />YYPE: OI~-S~'I'E SEWAGE <br /> <br />PERN['I' OR APPLICAf'tON NO: 9024188 <br /> <br />CONTf.~.ACTOR, NO. <br />KO'f"f'RE, RAY <br />8513 5MAW ~ARE RD SE <br />AUI'AE.SVSLLE, OR 973~5 <br />PHONE: 364-2318 <br /> <br /> ~'f'E~ <br />S~fE EVALUATiON, FIRST LOT <br /> <br /> E}UPRLY: <br /> HOLES READY: NO WiLL CALL. <br /> EYAUJATION NU~ER: <br /> <br /> lNG DRAIN FIELD <br /> TANK PUMPED: <br /> NO+ <br /> <br /> OUAN'F'iT¥ <br /> <br />THiS RECEIPT <br /> <br />.aC4OUN'f' <br /> $1 ?5. DO <br /> <br /> $~75.00 <br /> $o.0o <br /> $0.oo <br /> <br /> $175.00 <br /> <br />R"EJ'4ARKS: 31'rE g¥AL 8AL OUE <br /> <br /> PA,.Y. E'E: ('~ v'~ RECE.t~'f' NO: <br />,~cE~vEo ~¥: P, .W~ ........................................... ~ .... , ....... ~'Y*~: ~ ~: 0 <br /> <br /> / <br /> <br />~ST~TI~ PE~ITS ~ST ~E ~TAIN~ BEdE BUiLDi~ OR SEPTIC I~TAL~Ti~ B~1~. <br /> PLAN R~ViEW: BY ....................................... DAIE .............................................. CITY JURi~DICTi~: ~Y ................... DATE:~'>. ....... ~ <br /> <br /> <br />