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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. ¢'25 ' <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE $88-§147 <br /> coDE-.~-RHONE .¢:30 P.M. · 8;OO A.M. <br /> <br /> Othe.r <br /> <br />DATE-' 05/!2/87 TIME.' 9:$4;!0e <br /> <br /> · 4EAL'"O,RS, HAk-"OL6 & <br /> <br /> ]0107 DONALD RD NE <br />~ L;.%'O¢~,. OR 97002 <br /> <br />StGNATURE OF APPI.ICANT: <br /> <br />40793-0O0 <br /> <br />CONSTRUCT/ON TYPE; <br /> <br />LOT: <br /> <br />:;~H()x4 E: 578-1849 <br /> <br /> ~LOCK: <br /> <br />TYPE'.- ON-SITE. SENAGE <br /> <br />PERMZT OR APPLICATION NO:. <br /> <br />L;ON. £¢Jz,~.. w.~, NO. <br />~']~-Z.,~.[~RE,. H~ROLD & ELAINE <br /> <br />PHONE: $78-1849 <br /> <br />19 <br /> <br />190g <br /> <br /> SITE NUMBER;' <br /> VALUATION: <br /> <br />AC <br /> <br />MATER SUPPLY: P~ <br />TEST HOLES READY= <br />SITE ~/ALUATION NUt48ER: <br />EX[STING TANK SIZE: · ]000 <br />EXISTING ~N F~ELD LINES: <br />SEPTIC T~K ¢:MHPED: 5-4-.8? <br />PR~IOUS NO- BEO~= <br /> <br />1076 <br /> <br />N. N <br /> <br />MAP; <br /> <br />459 <br /> <br />ALITHOR!Z&7 IO~f NOTICE - Ft.D. VISIT <br /> <br />Ou, T ZY <br /> <br />PAYEE~ <br /> <br />THIs RECEIPT <br /> <br />~;65.~ <br />$0,00 <br /> <br />SALANCE DUE <br /> <br />;NVO~CE NO: <br /> <br />¢¢ECEIVED BY'. P~ ?r'PE; CHECK <br />';~-Z'-" -.~.' ........... %- ............. ~-'~ ............................. <br />SE]: AT,A~E0 ~CUMk~T POR RE~IRE~S.OF ~-~Z~GE SYSTEM. <br /> <br /> .; , , . %. .., e.. ~ <br /> <br />NOODLEY, NAR[ON COUNTY <br /> <br /> <br />