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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO,, 225 ' <br /> 220 HIGH STREET NF. <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />I a~ performing WOrk on a property } Own Or OCCUpy,, ti <br />I am a registered builder' OR the authorized repre$$nfa Ye <br /> <br /> ~U~ OF ~D OF P~ECY <br /> <br />10637 STAYTON RD <br /> <br />StGNATURZ~ OF APPLICANT ~ <br /> <br />DAT$~ ........ <br /> <br />AUFSVI LLE <br /> g?$25 <br /> _.__L , N9 <br /> <br /> 8I~ C/O D~NIS OL~ <br /> <br /> 769-5088 ~ ~ITE NU~E~: 2~02 <br /> t V~ATI~: <br /> .............. ) ~[~": ]SECT ON:: ~TOWNSH P , RANG~ ) ZONE: : <br /> <br /> ~ 2. 00000 ', ~ , NO ~ <br /> <br />NATERSUPPLY; phi <br />TEST HOLES READY: <br />SITE EVALUATION NU.F~ER: <br />EXISTING TANK SIZE. <br />EX[STING DP, AIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br /> <br /> TYPE: ON-S ITE <br /> <br /> PEI~'4IT OR APPLICAT[0N NO: gO112D0 <br /> <br /> ~T~TOR, <br /> ~U~ 0F ~D OF P~PHECY <br /> 916 N BI~ C/O O~NIS OL~ <br /> STA~, OR, 97383 <br /> ~E: 760-5088 <br /> <br /> ' I (~ ~- . P~I~ R~IPTS , $0.00 <br />5 L9 <br /> <br /> R~RKS: SZTE ~AL FOR ~U~ ~89~ '~; -' <br /> <br /> <br />