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MARION COUNTY BUILDING INSPECTION <br />,,~ENATOR BLDG. NO. 22S <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 5,~5147 <br />CODE.A-PHONE 4:30 P_M - 8:00 <br /> <br />°WN~TE: 08/10/89 <br />s~lus ^~assFULTZ, RANDY <br /> <br />TIE= 4:01:56p <br /> <br />COUNTY NO <br /> <br /> 10047 STAYTCN RD E~E <br />v~,U~'i~LE OR 9?325 <br /> <br />occup~.c',' RE~:~OENT ]'A <br /> <br />3 <br /> <br />SITE NU~ER: 1445 <br />~oav'AL.UAT I ON = ZONE <br /> <br />~n nnnn ...... l~ N~ NO <br /> <br />~0 <br /> <br />TYPE: ~-SITE SE~,~iE <br />~ERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR. NO. <br />FULTZ. RAN~Y <br /> <br />9018054 <br /> <br />PHONE: 769-53~6 <br /> <br /> ITEM <br />~THORIZATiON NOTICE - NO ¥[$IT <br /> <br />PAYEE= FULTZ, <br /> <br />WATER ~UPPLY: PW <br />TEST HOLtm~ READY: <br />SITE EVALUATION NUMBER., <br />EXISTING TANK SIZE: 1400 <br />EXISTIN$ DRAIN FIELD LINE~: <br />SEPTIC TANK PUNPED: <br />PREVIOUS NO. 8EDRDOIv~: <br /> <br />, ~&JANTITY <br /> 1 <br /> <br />TOTAL AE~ED FEE~ <br />PREVIOJS RECEIPTS <br />THIS RECEIPT <br /> <br /> RECEIPT NO; <br />TYPE: CK CHECK ~': <br /> <br /> AMOUNT <br /> <br /> $60.00 <br /> $0.00 <br /> SB0.00 <br /> <br /> .$0.00 <br /> <br />19364 <br />1419 <br /> <br />PLaN REVIEw: 8Y~~ . 0ATE~ <br />RF]~4RK$: AUTH/ NO FIELD VISIT R~7692 <br /> <br />CITY JURISOICTION: 8Y ................. OATEn. <br /> <br />OFFICE COPY <br /> <br /> <br />