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MARION COUNTY BUtLOING ~NSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br />~,ALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR .CODE-A-PHONE: 588-7904 <br /> <br />The work will be performed by ~ recistered bulldeF, <br />Other ....... <br /> <br />SIGNATURE OF APPLICANT: ..... <br /> <br />tOwN,S're: 09/13/9 t <br /> <br /> HUME,. A~ I RE~I O~'l'l~ <br /> <br /> 260 ~T'F AVE __ ~-~"~ii~;' <br /> OEI'~I T OR 9734~ i.. ___.___ ' ' <br /> <br /> PHC~N~: 854-3522 SiTE NUIV~ER.* 2591 <br /> <br />tO~ ' ~L~K; .................. :~SHI~t : RANGE: ' <br /> ' s~c~.: ' ........~A~'I;~'~;~6~ .............. ', <br /> <br />w~o~.: 1 ~E~:' .~ ......... ; ......... ~., ' ' ' 6E. .' .... tO5 <br /> : ~.~ ......~ ..................... u~r~ lG--~a;"~8}; .............. ~i co..~.: .... <br /> ~ 0m ....... ~.~ ........... 1,35q~,, , ~ .......... s6._j ............... ND,,~ . y~ .......... <br /> <br />'IYP~: ON-SiTE 5F-.'~A~E <br /> <br />PE'~lil ga APPLICATION NO: 33501 <br /> <br />CONI-RACTOR, NO. 1~5916 <br />STAYFON HiLL CiTY SlLVERT~ <br />4~1155 STAY'FC~I ~CiO DRIVE, SE <br />SI'AY'TON, OREGON 97~83 <br />PHONE: <br /> <br />WATER ,~UPPLY t <br />TE'~T HOLES READY: <br />~iTE EVALUA'rI~ NU~ER.. <br /> <br />~I~TiNG O~[N FiEL0 LiN~: <br />SEPTIC T~K <br />PR~WI~ NO. 8EO~: <br /> <br />BALANCE ~JE $0- oo <br /> <br />PAYEE: .INVOICE NO: <br /> <br /> RECEIVED BY; ¢] , .' · . tYPE. CHECK <br /> <br /> THIS I~ A VALID ~IT ~ '~15 ~IT ~l~ 360'~ F~ ITS t~E ~TE, IF <br />~T~Ti~ FAI~ TO ~EET A~.'R~I~TS ~ STATE ~ ~O ~i~ ~NTY ~ILDING <br /> <br />RE~F~RKS; ~AJOR REPAIR WITH ~,5~'I' <br /> <br />OONALD E. ~OODLE:Y, ~ARiON COUN'FY ~UILOING OFFiCiAL / ~Y <br /> <br />OFFICE COPY <br /> <br /> <br />