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SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />1 em performing work or~ a Prol~erty I own or O~u~y, <br />I am a registered builder OR the ~uthorized representative ~IGNATUR~ O~ APPUCANT'. ,, <br /> of e registered builder. <br />mh~wOo,her_ tkwiH be performed by a registered builder. <br /> <br />thi~ document <br /> <br /> OWNER'. 'gATE: 09'/09/?,~ .... T'3;HE~' ],0~38: 0~ ...... TA)~ LdT ...................... <br /> <br /> TOWLES~ CARL F, .~,~.;~80%0.0.0 <br />'~i:TUS ADDRESS ......... CONSTRUCTION TYPE <br /> <br />CATEGORY <br /> <br /> RESIDENTIAL <br />OCCUPANCY <br /> <br /> 1;~8~0 MURRAY LN NE CONTRACT CITY'. JGB'. OCCUPANT LOAD: <br /> AURORA OR ?7002 MARION COUNTY NO <br /> <br />MAILING AOORES~ SU BOIVISION: <br /> <br />TIGARD OR 97224 ' SiTE NUHSER: 9:3-031B2 <br />PHONE: 639-4844 VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br />PEEHIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />TOWLES, CARL <br />1291~ SW FISCHER RD <br />TIGARD OR ?7224 <br />PHONE: <br /> <br />9B49774 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 83-1868 <br />EXISTING TANK SIZE: <br />EXISTIN~ DRAIN FIEL~ LINES: <br />8E~,T,IC~,,TANK PUMPE~: <br />PREVIOUS NO. BEDROOMS. <br /> <br /> ITEM <br />STAN~AR~ ON-SITE <br /> <br />PAYEE: CARL F <br />RECEIVED BY: MB <br /> <br />SEE ATTACHED DOCUMENT <br /> <br /> $ THIS IS NOT A <br />FOLLOWING MUST BE <br />ALL NECESSARY <br /> <br />'TS <br /> <br />QUANTITY AMOUN~ <br /> 1 $255.00 <br /> <br />$255.00 <br />$2§5,00 <br /> <br />$0~00 <br /> <br />RECEIPT NO: 52141 <br />TYPE: CK CHECK ~: <br /> <br />A RE¥IEW PROCESS WHERE THE <br />fHEAPPLICANT TO ASSURE THAT <br /> <br />PLAN REVIEW: BY <br />REMARKS: STD <br /> <br />Ol,l: BY .......... DATE <br /> <br />OFFICE COPY <br /> <br /> <br />