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04/20/87 <br />B ROl~, NAYNE <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 . <br /> ~.~(~ 220 HiGH STREET NE <br /> -- ,"b ~ .~ALEM., OREGON 97301 <br /> L~ ~ COD~.A.~HONE 4,30 P_M. - 8:00 A.M. ' <br /> <br /> m e~ rml ~ <br /> <br />OtherThe work wil~ ~ ~d~m~ by s ~:~ered~ bvilder, ~ <br />T~M~t 10= 11=03a <br /> <br />PHONE: 745~1380 <br /> <br />TYPE;., ON~{TE SEiaJAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONT P, ACToR, NO_ <br />S~, NAYNE <br />SAME <br /> <br />PHONE: 749-1380 <br /> <br />AUT Oi TZON ,NOTZC - F o. viSIT <br /> <br />PAYEE: $~N. WAYNE <br />RECEIVED 8Y~ DM <br /> <br />, CONSTRUOTION 7YPEt <br /> <br />! <br /> <br />17 ~ 8S ~ 1W EFU <br /> <br /> NATER SUPPLY~ PW <br /> TEST HOLE~ READY: <br /> 'SITE EVALUATION NUNSER: <br /> EXISTING TANK SIZE= <br /> EXISTING DRAIN FIELD LINE~?® <br /> SEPTIC TANK PUMPED: 4/1/87 <br /> HOLDING TANK AGREEMENT: <br /> <br /> AFFIDAVIT: <br /> NINTEE I'~TER CHECK: <br /> <br />TOTAL A3S~ED FEF.~ <br />PREVIOUS RECEIPT~ <br />THIS RECEIPT <br /> <br /> INVOICE NO: <br />TYPE= OK CHECK <br /> <br />BALANCE 13JE <br /> <br />2S0 <br /> <br />QUANTITY NV~JNT <br /> $65,00 <br /> <br /> $65,00 <br /> $o.oo <br /> $6~.00 <br /> <br /> $0.00 <br /> <br /> 2161 <br /> 2008 <br /> <br /> Pr. lC, ANT TO .a~.~J~E THAT <br /> <br />'i'/~d~ ~C'~ I ON~ ~Y----i DATE <br /> <br />~";.~,.:;::' ,~ :; <br />'?2::'Z.';/.. ;/. <br /> <br /> <br />