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MARION COUNTY BUILDING INSPECTION <br />SENATOR B'LDG 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-PHONE: 588-7904 <br /> <br />NE <br /> <br />R~ OCK SECTION <br />DEPTH AREA <br /> <br />SIGN~'TURE OF APPLICANT <br /> <br />34. <br /> <br /> CoNTRAcT~IT9 ' U B <br /> <br />N~,~R,IQN COUN ~' <br /> <br /> / <br /> <br /> tlE NUll8 ER: <br /> V~L~&~ iON~ <br /> <br /> NO ~ <br /> <br /> CATEGORY <br /> OCCUPANCY <br /> :OCCUPANT LOAD <br /> <br />!9~58 <br /> <br /> MAP <br /> <br />c.(_)N YRAO I ON, <br /> <br />I'>~qr ,)N <br /> <br />9833708 <br /> <br /> L ~ t'v~ Or JAN T <br />~)N'->I TE 5"(.5 <: "OOO GAL <br /> <br /> l Ol AL ,~E,~,D FE~S <br /> PREVIOUS REC~IPf5 <br /> THiS RECEi Pl <br /> <br /> ~A~NCE DUE <br /> <br /> RECEIPT <br /> ~YP~: C~ CHECK <br /> <br /> I FOR R~QUIR~NfS OF ON-SITE SEWAGE SYSI <br /> <br />PAYEE: EDELWEI 5S b48 <br />RI;CEIVEU MY: CL 371'-':; <br /> <br />SEE ar f~(.;H~-L) DOCu <br /> <br />~ !Hi5 1.5 NO1 A/, THiS APPLICATION MUST GO THROUGH A REVIEW PROCESS ~TflERE THE <br /> <br />FORM # MC 15,56 REV 4/90 OFFICE COPY <br /> <br /> <br />