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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />ow. Eh: LUTZ. ~TARR E <br /> <br />SANE <br /> <br />TYPE.* CN'-~ITE SEWAGE <br /> <br /> PHONE 588-5147 /) <br /> CODE.A-PHONE ,4,:30 P.M. - 8:O0 AM. /~.~ ~.~ __ <br /> I am performing wol'k on a p,ope~y I own or ~cu~y. <br /> OR )the autharized representat~e sIGNATURE OF APPLIC~~~ <br /> <br />DATE: ~ 1/04/81 TZ~E: 3;41:~9p <br /> .................................. ' <br /> <br /> 6898 ~E~ RD SE , .....................................: ............... <br />~VZ LLE OR 9?325 ~T~ <br /> <br /> ..................................................................... · ~. <br /> ............................................. ................................................. <br /> <br /> : ~ITE NU~ER ~ 3023 <br /> <br /> · eL~; ,,~b~oh: ................. ;'fS~m~ ............................................................. <br /> · 1W ~ E~ ' 48 <br /> 20 8~ <br /> <br />[~ATER SUPPLY: <br /> <br />PE~,IIT OR APPLICATICN NO: 9005386 <br /> <br />LUTZ, STARR E <br /> <br />PHONE: 749-2169 <br /> <br />AUTHORIZATION NOTICE - FLD, VISIT <br /> <br />I'E~T HOLE~ READY: <br />SITE EVALUATION NUNIgER: <br />EXISTING TANK SIZE: 1000 <br />IlXISTING DRAIN FIELD LINE,~: <br />SEPT.[C TA~NK PUMPED: 11-2-87 <br />PREVIOUS NO. BEDROON$: 2 <br /> <br />~J~J~tI TY <br /> 1 <br /> <br />At, IOUNT <br /> $65.00 <br /> <br /> $0,00 <br /> $65,00 <br /> <br /> ':,PRE-VtOUS,,,REOE I P~ <br /> <br />P~ R~I~: 8Y 0ATE. ~ ,' ......CI'~' JURISOlC~ : BY <br /> <br />FO.M # MC 15,~. "~fV 6/87 OFFICECOPY <br /> <br /> <br />