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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 />SIGNATURE OF APPLICAN'~ <br /> <br />03/13/91 <br /> <br />JCHNE~N, Jl~l <br /> <br />TJX:" 17:1Z:21 <br /> <br />. 33350,-oBo-$~ <br /> <br /> ~ZTE NU~I~ER: 530 <br /> ..... YALUA~[CN; <br /> <br /> EPU <br /> 6 <br /> <br />, .AC ...... ,=,NC~ ...... ~O -, .......... <br /> <br />'TYPE: <br /> <br />PERhIIT OR APPLiCAT~C~ NO; 9030628 <br /> <br />~ TRACTOR, NO. <br /> <br />SANE <br /> DAY 682-24:20 <br />PHONE: 678-5'133 <br /> <br />HATER SUPPLY: PH <br />TE,,~T HOLE~ REACtY: <br />E, ITE EVALUAI",[ON NUIV~IER: <br />EXI,.~TENG TANK SIZE: <br />EX[ST,[NG DP, AJ[N F.[EL0 L,[NET'-'-~: <br />tSF_.PT~tc TANK PUt,IPED: <br />PREVICAJ5 NO. BEDRf. X3*'~: <br /> <br /> I TF_.~ ~XJ~N T ~ TY /~vlOlJN r <br /> AUTHORIZATION NOTICE - NO ViSZT I $60,00 <br /> <br /> PR~i~S- ~iPTS ~105. O~ <br /> <br /> PAYEE: J~. JiM RECEIPT N0~ 32657 <br /> R~EIVED BY: GL ~,~..,~,;,; ~-, ,.---.,. ,=% ~_,~ .... ., ..... ~. TYPE: CK , ~ECK~: 0 <br /> <br /> ~EE ATT~E0 ~T ~R RE~i.R~T~ ~ ~ITE ~E S~T~. <br /> <br /> ~ THI~ 1~ NOT A ~IT. ~[S A~T[~ ~T ~ ~ ,A ~E <br />~N~ ~T BE ~T~- ZT ~: THE ~IB~L~ OF THE APPL~T TO ~ THAT <br /> <br />PLAN R~I EN: BY DATE <br />REleARn: AUTH R~5230 <br /> <br />CiTY JURISDICTION= BY <br /> <br />DATE <br /> <br />¢0~, ~ ~-~ ~,~,, -.~ OFFICE COPY <br /> <br /> <br />