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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE $85-$147 <br />CODE-A-PHONE 4:30 P.M. · 8:00 A,M. <br /> <br /> I I am performing worR on a prOperty I own or occupy. <br /> I em ~ reglslered builder OR ( the authorized rebrese~tatiye $1GNAYURE OF APPLICANT: ............................. <br /> OI a registered bU}lder. <br /> ) The ~tk wlll be performed by a registered builder. <br /> ) Othe[ <br /> } I have read and agree to ~he terms sl~ed 0n e mveme sl · o DATE: ............. <br /> <br />DATE: 0e/24/87 TZ~E= 8~31=5~a <br />~"; B~K, gR[~ .......................... ~"i~ Lb~: ........ ,i'~m~°"v~ ~R~OAL <br /> <br /> ~053 M~LL C~EEK ~0 SE ~ <br />AU~VJLLE OR 9?325 ~ '~;~; ......... ~'"~; ........... ~' <br /> ~ ~N~ * NO ' <br /> <br />SANE <br /> <br />PHONE: 749-2132 <br /> <br />W~YH: 117 .D~PTH: 300 ~AR~A: 35100.0 ~UN~TS: SF IRm~¢.LOT: NO CO~ <br /> <br /> ~P~ ~-SITE S~E ~TER ~PPLY: ~ <br /> ~T HOL~ R~DY: <br /> P~IT OR APPL~TI~ NO: ,. 375g SITE ~A~ATZ~ NU~ER: . <br /> ~ISTING T~K SIZE: <br /> ~T~TO~, NO. ~ZSTING D~N FIELD LIN~= <br /> B~K. 8R[~ SEPTIC T~K ~NPED: 2-28-84 <br /> ~E PRiZeS NO. <br /> <br />PHONE= 749-2112 <br /> <br /> ..[TEN ,, , <br />,EX~[STIN~,.~Y~TEN E'VAL.. ,RPT. <br /> <br /> S:[TE NUIVlgER: 2195 <br /> VALUAT ICN; <br /> <br />25 i ~S ! 2W ~ AT <br /> <br />~on~ · ~c ,~,-~, .~v e~e, OFFICE COPY <br /> <br /> <br />