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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG_ NO. 225 <br />220 HIGH STREET NF <br /> SALEM. OREGON 97301 <br /> <br />,]ATE: 08/20/91 <br /> KING. JiM <br /> <br /> PHONE: ,5E~-5147 8:00 - 4:30 <br />24 HOUR CODE-A-pHONE: 588-7904 <br /> <br />I have rea~ aa~"a~ree to the tetras ~tated on t~e rew~e sl~e of <br /> <br />10~ GUY~4OORE DR[VE <br /> <br />DATE: ................................ <br /> <br /> ' ! $~1~,.' ........... <br /> <br /> 13 .1 <br /> <br />PERPIIT OR APPLICA'rlON NO: 34167 <br /> <br />CoN'r~.C ~ OR, <br /> JIM <br /> <br /> N~ <br /> <br />RE,5 ! DEN 1' ,~: <br /> <br /> NACKEY CR~E,~ <br /> <br /> $~[TE NUiV~ER: ?32 <br /> ..:,, VALUAT <br /> ,[ON <br /> <br />UNITS: IRREG. LOT: j ~ORNER: <br /> NO ; NO <br /> <br /> WATER ~PPLY: <br /> <br /> ~iTE ~ALUAT!~ NU~ER: <br /> <br /> ~i~TING D~iN FZELD LiNE~: <br /> SEPT [C T~K <br /> PR~i~ NO_ <br /> <br />(.~ANTiTY ,~,IOUNT <br /> $80.00 <br /> <br /> TOTAL .ASSE,,.qw,qw,qw,qw,qw,%sEP FEE'r.5 <br /> ~R~,,-"I'CU$ RECEIPTS $80.0~ <br /> · THIS RECEIPT $0.00 <br /> BALANCE DUE $0,00 <br /> PAYEE: iNVOICE NO~ <br /> R~C~IV~O BY; CL TYPE.: · C~E"CK ~: O <br /> ~EE ATTACH£0 ~A.7,J~NT FOR REQULRE~taN.TS OF:0N-SiTE SE"3~AGE SY'ST~. <br /> ·TH[S [~ A VALID PERI'41T ~' TH~ ~ERNIT,EXP[RE~'3~ODAY$ FROr4 ~¥$ Z~g~UE DATE. <br />OgI~$TRUCT/ON FAIL,~,.~~ ~'~t~q~,'"~A"L[~-' ~_~R~EC~t~E OF ~TAYE'LANS .~,ID MARION CCUNTY .UILD,NG <br /> <br />REMARKS: ~A. JOR REPAIR , <br /> <br />~XJNAL. 0 E. WCOOLEY, MARION 'COUNTY BUiLDiNG OFFiCiAL / BY ................................................................ <br /> <br />FORM ,~ MC 15-56 REV, 4/~ OFFICE COPY <br /> <br /> <br />