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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 2P5 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:O0 ~ 4:30 <br />24 HOUR CODE-A-PHONE; 588-7904 <br /> <br /> The work will be pedofmed by · registered bu~Ider, <br /> <br /> ~ L,, ,B~219~ ' ......... <br />i Si'fU~ ~'¢~: .......... ,; OONSTRUCTtON TYPE: <br /> ~UROR~ OR ~7e~2 ~R:[~N ¢OUNTY NO ~' <br /> <br /> i8~5 BRO~D OAK ~I..VD <br /> <br /> ,~ J.-,¢¢6,~ VALUATION: <br /> <br /> , 2.5: SC ~O ~ .......................... : <br /> <br />TYPE: OH-SITE SEWAGE <br /> <br />PERMIT OR APPLTCATIO~4 <br /> <br />CONTf~A~TOf% <br />YOUNI;,t 'rHO~tAS ~. <br />:t, 87~5 BF~OAD OA,~: BLVD <br />ALO4A~ 0~ <br />PHONE: ~ ' ~'~' = <br /> <br />46828 <br /> <br />WATER SUPPLY: <br />TEST HOLES READY: <br />SITE EYALUATION NUMBER: 42251 <br />EXISTING TANK SIZI~:: <br />EXISTING DRAIN FIEI_.~ t,,,iNES~ <br />SEPTIC TANK PiJHPE~: <br />PREVIOUS N0. <br /> <br />ITEM QUANTITY AMOUNT <br />T II,,E DEWATERING 1 <br /> <br /> TOTAL ASSESSED FF'ES <br /> PREVIOUS RECE],I TS $;;~6~,, <br /> <br />PAYEE: kECE, IIf NO: <br /> <br />SEE A1TAC'IED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTE~. <br />~.THIS IS A VALID PERMIT * THI P~ IT XP~R~ 8 S O I A~ E <br /> <br />REMARKS: 'TILE DEWATERII,I(; <br /> <br />DONALD E,, WOODLEY,~ HAI:;:~iOI,i COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM # MC ~-5~ R~V. 4/80 OFFICE COPY' <br /> <br /> <br />