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MARION COUNTY BUILDING INSPECTION <br /> SENATOR ~LDG. NO- 225. <br /> ~;~0 HIGH STREET NE ~ ~ <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 586-5147 <br />CODE-A-PHONE 4iS0 P.M. - 8:00/~M. <br /> <br />COLUM~ ]~A HELICOPTER~ <br /> <br /> 14452 ARNDT R0 NE <br />AUY~ORA OR 9?002 <br /> <br />DATE <br /> <br /> TAX LOT <br /> <br />[co~sT~uc~o~ "tYPe <br /> <br /> CONTRACT ~ITY <br /> <br />CATEGORY <br /> <br /> C~dER [CAL <br /> <br /> SITE NUMBER: <br />..... , .... , .VALUATION: <br />a TOWN~HIP = RAN(~E <br /> <br />3.00000 i , AC NO. <br /> <br />1555 <br /> <br />MAP <br /> <br />TYPE: ~N-~ITE SEWAGE <br /> <br />PEF~IT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 233?2 <br />FRED DOLMEN <br />2590 OXFORD ~T <br />N~tT LINN. ORE 9?068 <br />PHONE: 655-6956 <br /> <br />90043'26 <br /> <br />MATER <br />TEST HOL~S REAOY: <br />SITE EVALUAT[0N NUMBER: <br />EXISTING T~IK SIZE: <br />EXISTING DF4AIN FIELD <br />SEPTIC TANK PUMPE0: <br />PI~EVIOUE, ~. <br /> <br /> ITE~ (~UANTITY AMOUNT <br />STO ONSITE SYS < 1000 GAL : 1 $125.00 <br /> TOTAL A~ES~ED i~ $125.00 <br /> PiR~V~ R~CEIPTS $0.o0 <br /> .:i~IS ~EIPT $!~5_oo <br /> ,~CE ~E $0.00 <br />PAYEE: FRED ~LS~ ~ ~ ~ R~EIPT NO= 5286 <br /> <br />~ THIs I~ NOT A PE.~IT~ THIS /~iCATION ~ (~) ?rt~ A I~IE~ ~ i~Hl~ THE <br />FOLL~INGt4JST 8ECHO. IT iS THE ~ISIL[TYO~ll~E~APPt_~CAfl? TO AS~URETHAT <br />ALL NEC~SSARY INFO~TION HAS BEEN PROVIDED.~ <br /> <br />~MARKSt REPATR <br /> <br />OFFICE COPY <br /> <br />JURISDICTION: 8Y ...... <br /> <br /> <br />