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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDGI NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGO:N 97301 <br /> <br /> PHONE: 588-5147 ' 8:00- 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> Other .... <br /> <br />': 225 S PATTON SI' __ ]~ONTRAOT CITY; , UGS; [OCCUPANT LOAD: <br />~ ~T~O;[~ ............. OE ?7342 :~ 'L~[T~OZT ] NO <br /> <br /> 1218 3RD ST <br /> STAYTON, OR 97~8~ I SITE NUMBER.' <br /> PHONE: 808-3825&~ :i [ ~ALUATION: <br /> <br />, j ~; <br />L-- ' [ ~ ~--' <br /> <br />TYPE: OH-SITE SEHAGE : <br />PE~IT OR ~PPLICATIOH HO: <br /> <br />CONTRACTOR, NO. 84745 <br />Kevin N Hills <br />PO Box 465 <br />Betro&t~ 77342-~000 <br />PHOHE: 854-3797 <br /> <br /> ITEH <br />ALTERATION <br /> <br /> PAYEE: Kevzn N Hillm : ,:, <br /> <br /> ................ ====================== <br /> <br /> $ THIS IS HOT A PERH~T~ <br />FOLLOWIN~ HUST BE CO~PLETED~'~i:~;:~' I::S:THE: <br />ALL NECESSARY INFOEHATION <br /> <br /> WATER SUPPLY: CW <br /> TEST HOLES READY: , <br />~;~SITE EVALUATION NUMBER: <br />rr'EXISTIN6 TANK SIZE: <br /> EXISTINg DRAIN FIEL9 LINES: <br /> SEPTICTANK:PUMPED. <br /> PREVIOUS NO. BEBROOMS: <br /> <br />8E I::~T8:;: <br /> <br />QUANTITY AMOUNT <br /> 1 $255.00 <br /> <br />INVOICE NO: <br /> <br />$255.00 <br /> $0.00 <br />$255.00 <br /> <br /> $0.00 <br />57283 <br /> <br /> TYPE: IN CHECK 8: 0 <br />RESPONSI:BILITY:OF THE APPL. ICAN'r TO ASSURE THAT <br /> <br />ALT NOTE: CL~'~!CE.S~:::,~ENIE~ - file CL. OSED3 <br /> <br />FORM # MC 15-50 R~, 4/90 OFFICE COPY <br /> <br /> <br />