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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 />SIGNATURE OF APPLICANT: <br /> <br /> J F(ES )iDEH'I I AL, <br /> : CONSTRUCTION TYPE'. i OCCUPANCY: <br /> <br />......'' g'~'~ TdEAN AI..I._E:'Y F<OAD SJ.~'. i-c'6~fFA'dT ~l~Yi ~ 'OG'E~,. j OCCUPANT LOAD: <br /> <br /> AUH!iW]J_.!...E OR 977~2'5 : NARZ0i,I COUFf'i'Y] N0 <br />USE O~ gU~LmNG: ................................................. ]Nblb~ ~b~bo~: ' <br /> <br /> SI'TE NUMBER: 9~-0'1899 <br /> VALUAT]:OIq: <br /> <br />TOWNSHIP: ~ RANGE; J ZONE: <br /> I I <br /> <br /> ......... ~ ._.!!(~ ......... <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNIT OR APPLZCATION IlO: <br /> <br />WOOL, SE'.Y ~ DONALD <br />,SAHE <br /> <br />PHONE:: 749'-2444 <br /> <br />WATER SUPPLY <br />TEST HOLES REAl)Y: <br />SZTE EVAL, UAT]:0N NIJMBER: <br />EXIS'FIN¢~ TANK S~ZE: 500 <br />EXISTZ, Nf;; DRAIN FI:ELD LINES~ <br />SE?TlC TANK F'UNPE]): 4/26/91 <br />PRI'ZV~OUS NO. <br /> <br /> ~'k ~ QUANTITY AMOUNT <br />ANNUAl_ EVAL.. - <br /> <br />PR E v'Z 00,'"3 RE,r,,EZ F'T$ <br />TH:~;S [ F. CE,],FT <br /> <br /> I AY.E. ~IOOLSI,.Y, .DOWAk~ ~'.,'"r r,,,,.~ ............... l" <br /> ,'(E. CEI¥1:.D ;[.t. ~9 ~/~1~ ,f~ ........ ,~. ................. , ..... ::,.:., <br /> ..................................... 2: ::'.~Z:~~ .................................................... t r~- I;,. t,,iX L,~-H:;.[,,I% ~[: ,. //.,~ <br /> SEE AT'r~CI.,IE'~) i)O~J~[~-'~-~ ]T[~;~;~;'"';;'-~[;-;[::;:='";:::;::=-=': ........................................................................... <br /> <br />FOLLOW~;N~ MUST Bt:' C~ dP FT:'0 ~,~ .... <br />~L.L iiECESE;~RY ).'I',J;::0RN~7~h'"-~3 IT IS 'f'FE :~E?ENST~]'L'[TY 0F 'I'F)E APPLICANT T( Ac:~JrE 'Ff..~'f' <br /> )?EEN PROV I,OED,, ' ..... <br /> <br />REKARI~!~: HARD!;;H:!:I::' RENEhtCd,,, ~ <br /> <br />O 4 <br /> <br />FORM # MC 15.56 R~. 4]~0 OFFICE COPY <br /> <br /> <br />