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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO, 225
<br />220 HIGH ,STREET NE
<br /> SALEM, OREGON 97301
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<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br />Other
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<br /> ~828 ,~HAW HWY
<br /> A[.t~S'/Z~f.,t.,.E,~ [)R 9732~ S~TE HU~BER:
<br /> ...... o¢: oo.o VALUATION:
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<br />:'~'i0f"~ io~.. ~8 . , U~,T¢S ~ ~.~. ~Ol co~8,~8¢ 45
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<br />TYPE: ON-SITE SEWAGE
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<br />PER~IT OR APPLICATION NO: 46~40
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<br />Ct"~N'rRACTOF,'.. I,!0 ,,
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<br />J.:i.'L~7;¢ H:L;t. 1 C, reek Rd
<br />A!,tmsv:i. t !e,,
<br />PHONE: 7¢,?',',7744
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<br />WATER SUF'F'LY
<br />TEST HOLIES READY: I,lO
<br />SITE E:V.P,d..UATION I,IUH:6ER;:
<br />r-':X t ST lNG TANK
<br />EXZ[STIN5 DRAIN FIELd) L;[NES~
<br />S E P T ]: C 'I'A N K F'U H P J'.-:
<br />PREVIOUS NC),, BI'--:BROOFIS:
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<br /> I'iEH
<br />ST~Nlr)ARD OIq'-S!TE
<br />S]:~E EVAL. UAT];OI,h¢ J" l.r~oT ,..,OT
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<br />Q U A I,I T ]1 l' Y A i.i 0 U I,I "i'
<br /> :1, $ 2 6 5 ,, 0
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<br /> THIS RECE,I:PT $ ~),,
<br /> BALANCE IiUE $0.
<br />PAYEE: RECEZF'T
<br />RESEIVF_(b .... !::S~
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<br /> NC1TE; "' ,~ I)(]J!::S N?,T ¢;~Ai,IT O:;~ ]:HPI Y P:rF4H"S:"O',I '1" I!! ]' :(t [~q ' "J) ::'¢i:: i~l ::' (,, !'¢; f, )
<br />GNSTRHCTI[IN ;'~:i'~f[T; d ~'f' :C4::' ?~A'[::ED ~EFOI~'.¢."":(: i:l:l'f)l'!q(~ '0t-4~l_,- .... ~>"r' , .... [ilo'Al A ~'"¢,.,.I .,i~ ..,.. ,,,;'""'
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<br />FOnM # MC 15-56 REV. 4,~ OFFICE----"COPY
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