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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />2_'20 HIGH STREET NE <br /> SALEM, QREGON 97301 <br /> <br /> PHONE:588-5147 8:00- 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 .)/ , ~, <br />I am a registered builder OR he authorized represen ave s GNATURE OF APPI. CANT <br />of a registered builder. // ~/ .... <br />The work will be eerformed by a registered builder, <br /> <br />HATNAWAY, PHIL, IR RESIDENTIAt. <br /> <br /> AURORA OR <br /> <br /> ............................................................ AO ~i'9}~,6~ ............................ <br /> <br /> SANE ..................................................................... <br /> 19566 BUTTEVILt. E RD :MAIN ~ES SITE HUHBER~ <br /> PHONE.' 678-1857 VALUaTiON: <br /> <br />TYPE: OH-SITE SE~GE I WATER SUPPLY= PW <br /> TEST HOLES READY: <br />PEEHIT OR APPLICATIOH HO= 785~27~ SITE EVALUATION NUMBER: <br /> EXISTING TANK SIZE: <br />CONTRACTOR. NO. EXISTING ~RAiN FIELD LINES: <br />NATNAWAY~ PHILIP <br />SAME <br />1~5~6 BUTTEVtLLE RD :H~IN RES <br />PHONE: 678-1857 <br /> <br /> ITEM <br />REPAIR - MAJOR <br /> <br /> PAYEE:: HATHAWAY~ PHILi:P <br /> RECEIVED BYe" gL <br /> <br /> SEE AI'TACHE~ ~OCUNENT <br /> <br />ALL NECESSARY INFORMATION <br /> <br />:S <br /> <br />QUANT I TY A NOUI,IT <br /> 1 $125.00 <br /> <br />$125.00 <br /> $0.00 <br />$125.00 <br /> <br />$0.00 <br /> <br />Pl..AN REVIEW:: BY ......... ~= ,,.:: R: ,. BY ........... <br /> <br />REMARKS: f4AJOR REPAIR FORMS GIVEN FOR'"SITE ::RREPERATIQN <br /> <br /> RECEIPT NO: 557~2 <br /> TYPE. CE CHECK ,~. ~085 <br /> <br />~HE APPLICANT TO ASSURE THAT <br /> <br />DATE <br /> <br />FORM # MC 1 ~-§8 R~V, 4/ejO OFFICE COPY <br /> <br /> <br />