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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO. 225..,. <br /> 220 HIGH STREE'-T NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE $88-5147 <br />CODE-A-PHONE 4:30 P,M, - 8;00 <br /> <br />DATE: 12/JI/~9,, TIME: 12:$6:56 <br />, ow~eh~ <br /> CHURCH OF GOD OF pROPHECY <br /> <br />61231-000 COI~IEEC l AL <br /> <br /> 10637 STAYTON RD 8E <br />AL~VILL$ OR g7325 <br /> <br />U~[ OF 8UILDING' <br /> <br />200 <br /> <br />g16 N BIRCH C/O DENNIS OLSQ"q <br />STAYTON. OR. 99383 <br />PHONE: 769~5088 <br /> <br /> 17 <br /> WIDTH IDE ~'TN~ A~,I~A ' ' <br /> 2. <br /> <br />TYPE.+ ON-SITE SENAGE <br />PE~IT OR APPLI~TI~ NO: 11230 <br />~T~CTOE, NO. <br /> <br />~TA~, OR. <br />~: 76~5088 <br /> <br /> ITEN <br />SAND FILTER <br />SITE E'VAL. - FIRST 1000 <br /> <br />SITE NUMBER= 2302 <br />V.a/,,UAT I ON: <br />'~,~6~" ~ zO~ <br /> <br /> NO NO <br /> <br />IAtA'J*ER SUPPLY: <br />TE~T HOLE~ RF. AOY: <br />~ITE EVALUATION NU~ER= <br />~ISTIN~ T~K SIZE~ <br />~ISTI~ D~IN FIELD L~N~ <br />~IC T~K ~ED: <br /> <br />: MAP' <br /> <br /> 60 <br /> <br />ToT/u. A.~EE~ED FF.E~ <br />PP, EVIOJS RL=CEI PT'3 <br />THIS RECEIPT <br /> <br />DUE <br /> <br />1 <br />1 <br /> <br />PAYEE: CHURCH OF GOD OF PR(3~HI~Y RECEIPT NO: <br />RECEIVED BY: 13~ .: : :.::.' : ..... :~ ~ :~ . TYPE: <br />sEE ATTACHED DOCUMENT FOR REX~UIPJ~ENT$ OF ON-SITE ~EHAGE <br /> <br /> [300.00 <br /> 175.00 <br /> <br /> 1475.00 <br /> 340.00 <br /> 135.00 <br /> $0,00 <br /> <br />21999 <br />1652 <br /> <br />R~RKS: SITE EVAL FOR CHURCH R~4898 ,E,~DFILTER ~ <br />DONALD E. I,*X:~ODL~, le/ARI(3~l COUNTY 8LI[LDZNG OFFICIAL <br /> <br />OFFICE COPY <br /> <br /> <br />