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MARION COUNTY BUILDING INSPECTION <br />SENATOR EILDG. NO. 225 <br />220 HIGH -~TREET NE <br /> SALEM, OREGON 87301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P,M- - 8:O0 A.M. <br /> <br /> f hew read and agree tO ~h¢ i~ ~ated o~ the reverse Side of OATS: .......... <br /> <br />~TE: 04/26/8~ TINE: 11~11~26a <br /> <br /> H~[TT, DESERT & J~E : : <br /> <br /> 14122 A~DT RD <br /> <br />97002 <br /> <br />25 <br /> <br />'r~PE~. 0N-SITE SEWAGE <br /> <br />PERt, lIT OR APPLICATION <br /> <br />CX:)NTRACTOR, NC). <br />HE'ITT, DEL~ERT & JOYCE <br /> <br />I:~0NE.' <br /> <br /> ~ SITE NUN~ER=.' 1075 <br /> i VALUATION: <br /> <br /> ..................... ~ ............................. : EFU 3 <br />'DEPTH: Aml[.'~ 3. 87000 UNIm: A~ , <br /> <br /> IA~TEE ~JPPLY., <br /> TEST HOLE~ READY,- <br /> SITE EVALUATION NUNIBER.* <br /> EXISTING TANK SIZE: <br /> EXISTING DP-ut. IN FIELD L~NE~= <br /> SEPTIC TANK PUNPED: NO <br /> PRE"VIOt~ NO. BEDROOMS: <br /> <br />AUTHORIZATION NOT~CE - FTELD VISIT <br /> <br /> QUANT'~TY A~CUNT <br /> 1 <br /> , oT .,,ASs =S£D ' EES OD <br />: .I:~EVI~;tJS RECEIPTS $65.00 <br />THIS RECE;~,pT ', ,, $0.00 <br /> <br />,. I~L:ANCE DUE $0.00 <br /> <br />PAYEE= '" RECEIPT NO: <br />RECEIVED ~Y: ~ . ., ~_ ..._._.._...~.~__ '/tYPE: CHECK At: <br />SEE ATTACHED DOCUMENT FOR REQUzR,.'E~4E~TS <br />~_ THIS IS A VALID PEI~IiT ~ THIS <br />~i~JCTI(;N FAI~ TO ~ ALL ~[~, '~,.~A~' .~ ~I~ ~ ~ZLDZ~ ~D <br /> <br />R~/~J,R~,~: A~TH.FOR OFF~REFODEL R:1;8837 :: <br />0ONALD E, NOOOLEY, MARION CO.~I'Y BUILDI~NG 0FFIbi:AL '/ SY <br /> <br /> <br />