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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: $88-$147 8:00 J 4::30 <br />24 HOUR CODE-A-PHONE: 588.7904 <br /> <br /> OLA~ OHPORO, ~ ~ 4058?-000 l RESIOE[~t 1AL <br />SITUS AODRBS~ ........... I'~DI~ZfRUd'ri~N ~PE ....... J OC~UCAN~Y '~ <br /> <br /> AU~RA OR 9?002 ~ ~ ~ J ~ <br /> .......... ~ .............. NO ......... ; ~ ~F~-;~ ~ <br /> USE OF ~UI~DING ........................................ ~N0 0 O S ~ , <br /> <br />IYP~:: ON-SirE SEWAG~ <br /> <br />PEF,~vltf ON APPLiCAI[ON NO: <br /> <br />CC,'NfRAGfOR, NO. <br />~LATCH~ORD, LYON <br /> <br />PHONE: <br /> <br />3493~ <br /> <br />$iIE gYALUAflON NUMWER: <br />~XISTING lANK 5iZ~: <br />EXiSflNG URAiN FILL0 <br />S~PIIC ~ANK PUMP~Q: 2-~5-88 <br />PR~¥[OUS NO. BEDROOMS: <br /> <br /> iTEM <br />EKiS[~NG %YSfEM EVAL. RPI. <br /> <br />TOTAL ASSg~EB FEES <br />PREVIOUS RECEIPTS <br />THIS ~ECE~P'f' <br /> <br />QUANIITY AJ~OUNT <br /> 1 $'~oo,oo <br /> <br /> 100.00 <br /> $ooo <br /> <br />PAYEE: <br /> <br />BALANCE [~JE $r3 _O0 <br /> <br />iNVOiCE NO: <br /> <br /> RECE~,Vff~O '~Y: c'l , ~ IYPE: CHECK ~: <br /> <br /> THiS 15 A VALID PEBIT * ',~IS EBIT :¢1~ 360 DA~ P~ IT5 I~E DATE. IF <br />~ST~Ofi~ ~AI~ TO ~E~ ~,/R~I~T8 OF ,STATE ~ ~D ~Ri~ ~NTY BUILDING <br />Z~IN6 ORDiNal. THIS PEBiT '~LL B'B6 NULL' ~O <br /> :]' ,,: ,, <br /> <br />DONALD E_ ~DDLE~Y, ~tARiON 'Dl%JNlY f~U1LDING OFFiCiAL / ~Y <br /> <br /> <br />