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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 ~ 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />[ am a registered builder OR the authorized representative <br />of a registered builder, <br />The work wlll be pedormed by a registered builder, <br />Other ........ <br />I have read and agree to the terms Stated on the reverse side of <br /> <br /> DATE: ].2/J. OtDZ T',r HE: <br /> <br />'bWa-~'aT ~ E R'; '- T~'T ]'T~t ............................... ;-~-TZE6:r; .......................................... ~~L- ......... <br /> <br /> 12~22 FRY RD <br />AURORA <br /> <br />MAILING ADDRESS: <br /> <br />NE <br /> <br />VALUATION: <br /> <br />PHONE: 678-2247 <br /> <br />PEEHIT OR APPLICATION NS: S1~40 SITE EVALUATION NUMBER: <br /> EXISTING TANK SIZE: 1800 <br />CONTRACTOR~ HO. EXISTING DRA~N <br />FISFIER, NATHAN ', SEPTIC TANK PUMPED: 1'i/Ii/~ <br /> : PREVIOUS NO. BEDROOMS: <br /> <br />PHONE: 678-2247 <br /> <br />2~6 <br /> <br />TEST HOL~S READY: <br /> <br /> ITEM <br />AUTHORIZATION NOTICE <br /> <br /> SEE ATTACHED DOCUMENT <br /> <br /> · THIS IS A VALID <br />CONSTRUCTIO;~ FAILS TO ME <br />ZONING ORDTNANCES, THIS <br /> <br />QUANTITY AMOUNT <br /> <br />S <br /> <br />T[~.,E. EEI PT..N.O[.. <br /> ¥~1~_ ~ UH~.Ul~. ,~: <br /> <br />$160,,80 <br />$160.00 <br /> $0.00 <br /> <br /> FROM ITS; ISSUE ;)ATE. IF <br />A~!D MARION COUNTY [~UILDIN£; AND <br /> <br />SORM # MC ts.ss ~, ,~/~ OFFICE COPY <br /> <br /> <br />