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MARION COUNTY BUILDING INSPECTION <br />S6NATOgl BLDG. NO. 225 <br />;~20 HIGH STREET NE <br /> SALEM, ORI=GON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P_M. - 8:00 A.M. <br /> <br /> I em {3etforming work on e pro~erty own or occul)y <br /> <br /> of a r~ietered <br /> 1'he work will ~ ~d~med by a reglstere~ buHd~r. <br /> Other <br /> I have ~eed and agree to {he te~s Steted ~ the reverse side of <br /> <br />~= ~?~ TZ~= 11:.22~1~ ..... <br />~DT ~ <br /> <br />StGNATURE OF APPLIC~.NT~ <br /> <br />DATE; ................ <br /> <br />LOT: ~LOCK; <br /> <br /> TYPE; ON--~ITE SEWAGE <br /> <br /> PERffi/T OR APPLICATZON NO-- <br /> CONTRACTOR, NO. <br /> HEN[Ti', DELBERT & JOYCE <br /> <br /> PHONE: <br /> <br /> SZTENUI~EE~ 1075 <br /> VALUAT ION ~ <br /> i~I6N: ................. i'~(~¢N~'H~: ..... [ RANGE; { ZONE; . <br /> <br />,.,~ ............. Z ........... i ...................... 4S ...... j .................. ~,~ ....... J ................. Z~ ............ ~. .3 <br /> 3.g?O00 ; AC i <br /> <br />8046 <br /> <br />WATER,~LIpPLY= P~ <br />TE~T HOLES REAOY~ <br />SITE EVAUJATIQN NUMBER: <br />EXISTING TANK $~ZE= <br />EXISTING DRA~N FZELD LINES: <br />~FIC TANK PLINPED~ <br />PREV[~ NO. BE~: <br /> <br /> ITEM <br />CAPPING FILL <br />SITE EVAL. - FIRST 1000 C-,AL DSF <br /> <br />PAID August 31, 1988 <br /> <br />qUANTITY ANOJNT <br />1 $280.00 <br />1 $165.00 <br /> <br /> ~44~.00 <br /> 230.00 <br /> <br />RFJ~RI~: SITE EVAL l;~9815 NAI:~'-ISE ,. . ,':' .... <br />I:XDNALO E, VK:X3OLEY. MARION COJNTY 81.IILDING <br /> <br /> <br />