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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 - <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />lamaregister~dbui~derOR( )theauthorizedrepresenta ve <br />Other <br /> <br />this document. <br /> <br />OWNER'. <br /> <br />OCCUPANCY; <br /> <br /> , Ih,hlL.,, 749.-.-].;~8'? <br /> <br />WIDTH:~ iDEPTH: AREA: ; UNITS: , <br /> <br />............................ ~.~ .... ~ ........ ~ ......................~0 ::.~ - <br /> <br />TYPE: O~4-St:TE SEWAGE <br /> <br />PERMIT OR APPLIEATISN <br /> <br />(.,L, ~ f ,~¢,(,701-. ....... <br />o I,..L ,,.,E ,,~ <br /> <br />PHONE= 749-~,3S7 <br /> <br />~846~18 <br /> <br />,~IATER SUPPLY".' <br />'TEES'¥' HOLES" REAP¥: <br /> <br />EXISI".ENC-TANK S~ZE: <br /> <br />SEPTIC TANK PUMPED: 4/7/9~ <br />PF~EVIOUS NO,, ~E'DRO0~S: <br /> <br /> I T E H B U AIq'l' I T Y A M f_)t.~',,t'i- <br /> AUTHOR]iT~AT];~iN NO'Ti;CE -.. N9 V'.~S];T ]. <br /> <br /> 'fH!S <br /> <br /> PAYEE SI;3..~E*, JA~,~T_ ~ RECEZF": <br /> ..... : Z 2..._% ........ 2 ........... 2L %:% %~~%::::%;=;= % q2:;: :%=::%%% %: ;::; ..................................................................................................................... <br /> SE(~ AT'T'ACHEI) ~OCUMENT FOR REQU]:REHENTS OF O!,4-S];TE SEWA(;E SYS't'EN,, <br /> <br /> ~ THiS IS NO~ A PER~IT. TH~S APPL~CATIO~ <br /> .... ~1 f._l .......... ~. ] ...... ~ L., k,_S Ol~,)~.:~_.,.t, Y 0,-. .-~,~ AI--LICA~,~ ~( A,_=J.,.. 'iq,!AT <br />ALL I,%CESSARY ];NFORHAT];ON HAS [4EEN <br /> <br />FORM ~ MC 1~-~ R~, 4/~ OFFICE COPY <br /> <br /> <br />