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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 />I am a registered builder OR ( ) the authorized representative <br /> <br />The work will be performed by a registered builder. <br />Other <br /> <br />i~'~ifO~ ~OCi~: / CONSTRUCTION TYPE; OCCUPANCY; <br /> <br />' ~ViLL[ UN ~/azo MARION COUNTY NO <br /> <br />~ ~ ~j ................. UNITS; .................... ~[~ ...................... ;~, <br /> ......... ......... L ................. ......... <br /> <br />7.95 AC NO NO <br /> <br />TYPE) ON'8ITE BEWA§E ) WATER SUPPLY: PW <br /> I TEST HOLES READY: <br />PERNIT OR APPLICATION HO: 52157 I SITE EVALUATION HUMBER: 42914 <br /> EXISTING,~A~KSIZE: <br />CONTRASTOR~ NO. ' LINES: <br />BEHUT. CHERYL SEPTIC TANK PUMPED: <br />12~9 EWALD AVE'SE PREVIOUS NO. REDROOHS: <br />SALEM 77392 <br /> <br />STANDARD ON-SITE SYSTEM :~!: <br /> <br /> PAYEE: <br /> RECEIVED BY: pi) .... ._., <br /> <br /> SEE ATTACHED BOCUNENT <br /> ~ I~FIIS IS A VALID PER'Il <br />CONSTRUCTION FAILS TO; <br /> <br /> RECEIPT NO: <br />TYPE: CHECK ~: 0 <br /> <br />AMOUNT <br /> $255.0~ <br /> <br />$255.88 <br />$255.98 <br /> <br />$0.08 <br /> <br /> ITS ISSUE DATE. IF <br />MARION COUNTY BUILDING AND <br /> <br />ZONING ORDINANCES, THIS <br /> <br />~EMARKS: <br /> DONALD E. WOOBLEY~ MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />