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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG_ NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON g7301 <br /> <br /> RHONE' 588-5147 <br />CODE-A-PHONE 4,30 P,M, - 8,00 A.M. <br /> <br /> affl 13Q~O?~IR{i work On a property I own or oc~p¥. <br /> I em a te~lateted builder OR ( ) the authorized ceptesent~tiYe <br /> <br /> Other .... <br /> <br />0ATE: 06115187 TIME: 4:0'/:33p <br /> <br />UNITED ST'AT~ I',I~HAL SET~/ICE <br /> <br /> $991 EDCLIFF CT <br />AL.~V I L. LE <br /> <br />OR <br /> <br />SE <br /> <br />FRED PJRDY - REAL I~TATE <br />383g RIVER RD $ ,,SALEM 97302 <br />PHONE: 581-8888 <br /> <br />LOT ELOCK ;~ECTION <br /> 6 2 12 <br /> <br /> ~T~TO~. <br /> UNITEO STAT~ ~AL SERVICE <br /> FRED ~OY - R~L ~TATE <br /> <br /> ~E: 581-8888 <br /> <br />~I{INATURE OF APPLICANT <br /> <br />LOT <br /> <br /> ~ N <br /> <br />CATEGORY <br /> <br />OCCUPANT LOAD <br /> <br />CASCADE PARA <br />~~,~-.. <br /> <br /> VALUATION: <br /> <br />N <br /> <br /> RANGE ZONE <br />AC Ifi~ LOT y CORNe~ <br /> <br />;,.~J'ER ~UPPLY: PW <br /> <br /> SITE ~A~AT[~ NU~ER ~ <br /> ~ISTING T~K SIZE; goo <br /> ~ISTING D~IN FIELD LIN~; <br /> ~TIC T~K ~MPED= <br /> P~I~S NO. 8EO~ <br /> <br />R <br /> <br /> i TEM <br />~XISTING SY~TEN EVAL. RPT_ <br /> <br />PAY~'E; <br />RECEIVEO BY: PB <br /> <br />QUANTITY AMOJNT <br /> 1 $60_ <br /> <br />TOTAL A~ED FEES <br />PREVIOUS RECEIPTS <br />'~IS RECEIPT <br /> <br />$0.00 <br />$0,00 <br /> <br />~LANCE DUE $0.0o <br /> <br />INVOICE <br /> C~ECK <br /> <br /> TYPE: <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIK~NENTS OF ON-SITE SEWAGE <br />* THI~ IS A VALID PERMIT ~ THIS I;:'~.I;~IT EXPiIRI~ 360 DAY~ FROM ITS <br /> <br />~~~7-540 R~SlO <br /> ~:X~NALO E. NOOOLEY. NARION CCL.~TY' BUlL.DING OFFICIAL / BY <br /> <br /> <br />