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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; 588-5147 8:00- 4:30 <br />~4 HOUR CODE-A-PHONE: 588-7904 <br /> <br />CHURC~ OF GOD OF PROPH~b-'Y <br /> <br /> 10637 ~TAYTON RD E~E <br />AUNSVZLLE OR g7325 <br /> <br />~IGNATURE OF APPUCANT <br /> <br /> 61~21--000 <br />CON81"RUO'~ION ?¥~m OCCUPANCY <br /> <br /> CONTRACT CITY i UGB IOCCUPANT LOAD <br />MARl..ON _CONJ...NTY, ! NO ; <br /> <br /> BIRCH C/O DENNi~ O~ <br />S)AYTON, OR. 97383 <br /> 769-5088 <br /> <br />TYPE: QN-~ITE SEWAGE <br /> <br />PE~ZT OR APPLiCATiON NO: 37010 <br /> <br />C~NTRACTOR, NO. <br />C,'HUECH OF GOD OF PROPHECY <br /> BIRCH C/O DENNIS OI.SQ~ <br />STAYTON, OR. g7383 <br /> 769-5088 <br /> <br /> ~ SiTE NUi~BER = 2302 <br /> " VALUAT ION: <br /> <br /> gE~ : lW ~ EFU UO <br /> ~ : NO ' N0 <br /> <br />~TER ~PP~Y: ~ <br /> <br />SITE ~ATI~ NU~ER: <br />~ISTING T~K ~&Z~ 1500 <br />~[STING D~IN FIELD LiN~: 300 <br />~TIC T~ <br />PR~I~S ~. <br /> <br /> i tEN {~U~JT 1TY ANOUN T <br />STANDARD ON-SITE SY~T~I 1 $170.00 <br /> TOT~ ~ED ffE~ $170,00 <br /> PR~I~ R~EI PTS $170.00 <br /> <br /> ~E ~E $0.00 <br />PAYEE: R~JPT NO: <br />RECEIVED BY: ~2 TYPE: ~ECK ~: O <br /> <br />SEE ATT~EO ~M~T ~ ~[~T~ OF ~TE ~ ~T~. <br /> <br />RE~v~A~. MH ?O HCOK TO EXiSTiNG CHURCH ~Y~TE~ ~r11230 <br /> <br />DONALD E. NQOOLEY, rV~i0N COJNTY I~JiLDING OFFICIAL / BY <br /> <br />OFF[CE COPY <br /> <br /> <br />