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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 />lamaregisteredbuHderOR( ) the authorized representative <br />of e registered builder. <br />The work will be performed bY a registered builder, <br />Other <br /> <br />'H)44S hAZE F_-R,:'EN <br />F'HONf:!i ,)YS -424~ V~I_U~TION= <br /> <br /> ~DeefH; J Aa EA'. <br /> <br />TYPF: ON-SITE SEWAGE <br /> <br />PEEHll' OR AP~'LTCATION <br /> <br />I"I.,ONK~ 854- ;~'797 <br /> <br />&1217 <br /> <br />~ATER SUPPLY: [;k~ <br />'TEST HOLES READY: <br />SI'rE EVAI_.UATZ(',~N NUMBE'R:: <br />ffXI:STIN6 TANK SIZE~,, <br />[{XISTIN(~ ~RAtN F;UiL~ L,INFS~ <br />SEPTIC TANK F'U~PED~ <br />PREVIOUS NO. BE~)RODHS: <br /> <br /> t; T i;N'4 EL) ANT t'l'Y <br />!i;'fAN/)ARP ON,-,. ]7E. SYSTEM t <br /> <br />Fcc,, i,']VOICE <br />C(':.IVF;P <br /> <br /> $ THIS IS A VALID PERMIT $/',T~IS PERMIT ,EXPI'RES '3~8 BAYS FROM ITS ISSUE DATE. IF <br /> ~..~,~t...,,I:OH )A..,.S TO M,..,.F,ALL,RL~UIREME~TS,OF STATE ~AWS AND MARION COONTY E,U!..I).%,g /~','I'~ <br />:~{'~,[1'~,~(, [')RI~]NANCF~S,~ FH1S P~RH~T SHALL"BE. G0~E ,NUL) AND VOID. <br /> <br /> OFFICE COPY <br />FORM # MC 1 ~,~6 REV, 4/90 <br /> <br /> <br />