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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: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />other, <br /> <br />S~GNATURE OF APPLICAN ..... <br /> <br />OWN~: ..................... l-¥Z~"Lb'f; ........................ ]'C~f6GO~¥: <br />! THERRI EN, HARRY RE$10EN T iA[ <br /> <br />J <br /> <br />; 7771 'f'ENRANCE LN SE <br />' AUr4~VILLE OR 9'13~5 <br /> <br />CONTRACT CITY: UGB: OCCUPANT LOAD: <br /> 'COUNTY NO <br /> ' ~o' <br /> <br />SAJ'4 E <br /> <br />PHONE: '749-2666 <br /> <br />TYPE: ON-Si'rE ~E~AGE <br /> <br />PERt4i'f' OR APPLiCA'f1ON NO-' <br /> <br />CC~'I RACTOR, NO, <br />f'BERRi EN, HARRY <br />SAreE <br /> <br />PHONE: 'IA9-2666 <br /> <br />9034321 <br /> <br />WA'rEP SUPPLY: PIN <br />'fESf HOLES RP2AOY: <br />S['FE EVALUATION NUfV~ER: <br />EXi~T'iNG TANK SIZE: <br />EZXlB'T'LNG D~IN FIELD LINES~ <br />SEPTIC T~K ~MPED: <br />PRE~i~S NO. BED~: <br /> <br />PAYEE: THERRiEN, HARRY <br />RECEIVED BY: cl <br /> <br />ITE~ QU~U~TI]'Y 4J~OUNY <br />REPAIR - IVIAJOR 1 $80.80 <br /> <br /> $so.o9 <br /> :pREViOUS:RECEiPTS $0.08 <br /> THi'S RECEIPT' $80_00 <br /> <br /> , BALANCE OgE $9,00 <br /> <br /> RECEIPT NO; 36~89 <br /> TYPE= CK C~ECK ~: <br />SEE AT'f'A~ED ~'f' FOR :R:~IR~'~'S OF ~TE SE~AGE:,Sys"~ <br /> <br />~ THIS iS NOT A PER,liT. :: <br />/=OLLOWIN6 MUST BE <br />ALL NBDtDtSARY [NFOI~ATION <br /> <br />PLAN RE¥1E~: BY <br /> <br />REZ,*~ARKS: <br /> <br /> DATE <br /> <br />D~.AJOR REPAIR R~6'13I <br /> <br /> A'}REVIEW PROCEEG $~-IERE THE <br /> T~E APPLICANT TO ASSLIRE THAT <br /> <br />CiTY JURiSOiC'TiON: BY DAlE <br /> <br /> <br />