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MARION COUNTY DUILDING INSPECTION <br />SENATOR ELDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M,,- 8:00 A.M. <br /> <br />DATE~ 00/0?/9? TItlE: <br /> <br /> H~T~, KELLY ~E~)~L <br /> <br />~V[ LLE <br /> <br />A~ILLE. ~ 97325 <br />~E~ 749-2607 ; SZTE ~ 2067 <br /> <br />WIDTH; <br /> <br />DEP"rH: ^REA: ;UNITS: : IRREG· LOT; iCORNER: <br /> ~ 2.oo8oo i ......... ~ ...... i ..................... U__°..__i..,.NO .............. <br /> <br />TYPE.' ON-SITE <br /> <br />PEJ~4IT OR APPLICATION NO.' <br /> <br />CONTRACTOR. NO. <br />HAMPTON, KELLY <br />P.O,BOX 694, <br />AUNSV'rLLE. OR 9?325 <br />PHONE.- 749-2607 <br /> <br />3533 <br /> <br /> NATER ~JPPLY~ PN <br /> TEST HO.ES <br /> SITE EVALDATION NUIV~ER: <br /> EX[STING TANK <br />EXISTING D~AIN FIELD LINES= <br />SEPTIC TANK I=~IqPED: 5-8-84 <br />· PREVIOLI~ NO, <br /> <br /> ITEM . .. (QUANTITY ANOUNT <br />EXISTING SYSTEM EVAL. RI'T. :i.. .: .,....,........ 1 $60.00 <br /> ]'OT-A.~ .A,5~E~EO 'F~ $60. O0 <br /> , $60, O0 <br /> '~REV-tOU$.' RECE[pT~' <br /> ,: : ·,.'"'i~-T~'S'i' R~I':PT · , $0 · O0 <br /> .... ." :"'BX~O~ ~u~ ..' ,, ~o.oo <br /> ,,;,. .. .'.: , , . ',, <br /> PAYEE*. , '" · ' , "i ' ""RI~iPT NO: <br />RECEIVED BY: JB ' ' '; ...... '~x/~E{' "CHECK ~; <br />.......... &,~,~ : :: :~:=~,~ ,, ;.' ...... , , '~,~,,~,,~ <br /> <br />~ ~. ~zs ~ZT:~"~?~,:~,:~o~.'. ." <br /> <br />RF. NA~KS: E.$.R. FOR LOAN <br />DONALD E. NOODLE'Y, r4ARION COJNTY BUILDTN~ '0~F);~iAL / BY <br /> <br />O"M # MC t5.55 REV. 8/~7 OFFICE COPY <br /> <br /> <br />