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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG, NO. 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br /> PHONE: 588-5147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br /> ! CONTRACT DITY: UGS: i ODOUPANT LOAD:
<br />WAY DI;", S~: ·
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<br />MAIblNG ADDRESS:
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<br />SITE
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<br />69141
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<br />WATER ,,SUPPLY~ F'W
<br />TE'ST HOLES READY:
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<br />EX][SII!,IG YANK S[[ZE',',
<br />EXISTIN~ DRAIN Fi[ELD I,.,Zi',~ES:
<br />SEPTIC TANK PLi~PgD:
<br />PREVIOIJS NO,, BEDROOMS:
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<br /> ]'TEH
<br />;<×.t:S l']],l[:; ~ ' :"',:"~
<br /> , ~. ,n E:VAL. D, Pf,
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<br />TSTAL AS~J
<br />r,~E ¢IOLIS R~,OE,.F
<br />TH]/8 RECEIPT
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<br />GII.IANT L[ T Y A H [] Ui,',";'
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<br />BAt A~ CE I)UE ' '
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<br />P(;YF'[:,;; RECE:[PT I O.
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<br /> L :-:... /..D ~Y~! L.L, TY~%'5,", [,HE,,,', ' ';:)
<br /> ,,: ¢'l~h.,l(-,~) !),r,)l:;bM~:HT FOI~ P. EI:~U,f.R!~;Ht~:NTS OF OH-~S:Ii'FE SEWAGE
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<br /> * ,?-~Z$ ~$ A VALID PERMIT ~ TNIS PER~IT EXPIRES :~&e DAYS FROM ITS ZSSUE DATE. IF
<br />Cd!,/!.¢~!(UC'~,'.~.O!,f !~,.A,,71.~S '~f] NEET ALL RE~UIRE:HE:N'~S OF STA'f% LAWS AND NAR~O~,~ COUNTY 3::Z',.,D]'n";.
<br />~r)~L':N~,. ORD'.[~,[AHCE'3~ 1H.l'S PERMIT SHALl.. ~ECOHE: NULL AN~
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<br />,' .... 0I TY JC~J.~L.~,l~ 0~i~C;[(AL / ;BY . ...................................................
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<br />OFFICE COPY
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