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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
<br />CODE-A-PHONE 4:80 RM. - 8;00 A.M.
<br />
<br />01/17/89 TINE: 8.'40:57a
<br />WtAOS~ORTH, E~OTT
<br />
<br />RESIDENTIAL
<br />
<br /> ?76? AUBUS RD SE
<br />AUNSVILLE OR 9?325
<br />
<br />MARION CCUNTY NO
<br />
<br />SA~4E
<br />
<br />PHONE; 749-2419
<br />
<br /> 3O 85
<br />1,00000 AC
<br />
<br />SITE NUNBER: 2510
<br />VALUATION -+
<br /> ZONE;
<br />
<br /> NO YES
<br />
<br />TYPE: ON-SITE SENAGE
<br />
<br />PERH~T OR APPLICATION NO: 901~531
<br />
<br />CONTRACTOR, NO. ,
<br />
<br />PHONE: 749-2419
<br />
<br />TNAE~TER E~JPPLY= PW
<br /> T HOLES READY~
<br />SITE ~9/ALUATION NUMBER:
<br />EXISTING TANK SIZE:
<br />EX[STING ,DRA[N,,.FZELD LINE~:
<br />SEPTIC T~NK PUMPED= 9-14-$?
<br />PREVICU$ NO. DEDR(:K:)FI~ 3
<br />
<br />MAP:
<br />
<br /> 48
<br />
<br /> ITEN " ,.. - ,.,h,,, ,'QUANTITY AHOUNT
<br />ANNUAL EVAL. - TE3vlP OR HO~IP',I~_ i,' "".. '" , .... ' ...... ~' 1 $60.00
<br />
<br /> .......... ,,,,¥~TAI.: ASS~ED EEES... SS0.00
<br /> ,- "'" '"'~, ' :,':, ',', PREVIO,,.~,; RE'C1EI, PTS $0. OO
<br /> '"': '" ~[S' RECETPT $60.00
<br /> - ~' . "~~e',:~. ~E.. ,,' .... ' ' So.co
<br />
<br />PAYEE~ ~. ~ ,,' ,,.':,;, ":"~.~',,~,;,,,~. ~ ,,. ,.... , RECEIPT NO:.
<br /> 14347
<br />
<br /> ~ .,. ' .,,.,'~;~;';,¥;;;,,, ..,.... ~m.., , · ,:; .~....:. .r ~,~ ,,,..
<br />
<br />ALL N~ ZN~TZ~ ~.;,,,~,~O~:-..' ".. ,,::,',, '. · '""'
<br /> .... 4:.%¥ ",,,' .~.' .... ;,' ,,,, , · .
<br />
<br />P~ R~I~, 8Y TE~ ~ CI~ J~'I~D~CTI~, 8Y~_~ ~TE~__
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<br />OFFICE COPY
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