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MARION COUNTY BUILDING INSPECTION <br />SCNATOR 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-PRONE: 588-7904 <br /> <br />of ~, registered builder, <br /> <br />~SlTUS ADCRESS; ;OONSTRUOTION TYPE: <br /> <br /> r ," ' ~ ,. MARION COUN'fY <br /> h JM.W I _ 0~ 97325 <br /> <br />,, <br />~ F'HON~ :, ~64'"'~5 VALUATION: <br /> <br />CWIDTH: OEPTH ( A~EA: ¢ UNITS: IIRREG. LOT: ~ CORNER: <br /> ~ NO <br /> <br />PERMIT OR RPPLICATION NO: <br /> <br />,C, ONTRA CTOF(,~ NO,, <br /> <br />PO Box 21088 <br /> <br />P H 0 N E: 588 - ;I, I 15 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE ]!VALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING ])RAIN FIELD LINES: <br />SEPTIC TANK F'UHF'ED: <br />PREVIOUS NO. BEC, ROOMS: <br /> <br /> ITEM QUANT I TY <br /> PRESSURE D I STR):BUT.TON <br /> <br /> fOTAL AoSEoSE~ F'EE,~ <br /> PREVIOUS RECEIPTS <br /> ~ THIS .R.,.LEIPZ <br /> <br /> ,:: , :~ALANLE,~DUI:. ,: <br /> <br /> EEC~IVED BY MB ~A ~ YY~E CHE~K <br /> SEE AT'fACIlE9,0N-Si~E' SEWAGE SYSTEM. <br /> · TH~ ~S A VAL? PERMIT: THZS PERMIT ~XPI:EES ~&8 ~S FROM ~TS zqsuE BATE. <br />[,ONSTRUCTZOIq FAZLS TO MEE'f ACL REQg~REHENT'S OF,STATE LAWS AND MARZON COUNTY <br />ZON:[I,1G 0 ~2NAII(.E,~, THIS PERM2'I' SHALL: BELOME NULL AND VOI~. <br /> <br />E,,,.MAkKS,, SS: PI) <br /> <br />DOI'~ALD E. WOOI)LE'.Y, <br /> <br />MAl,~:rON Cb. ,IT Bt [l_Dd'k, OFFICIAl_ / BY <br /> <br />OFFICE COPY <br /> <br /> <br />