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MARION COUNTY BUILDING INSPECT ON <br />SENATOR B/DG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P M. ' 8:00 A,M. <br /> <br />JACKSON, JOE 8. ~< r4ILDRED <br /> <br /> $801 H~IST RD <br />AU~V[LLE <br /> <br />OR 97325 <br /> <br />I~IA.R ICl4 COUNTY NO <br /> <br />PH~E: 749-1700 <br /> <br />272 D~pT~ 100 <br /> <br />TOWNSHIP <br /> <br />TYPE: ON-SITE SENATE <br /> <br />P~P~IIT OR APPLICATION <br /> <br />CQNTRACTOE~ <br /> <br />B~ SLATER <br />~ ~OX 47? ~VILLE 97325 <br /> <br /> SITE NUFI~ER: 4~64 <br /> VALDATION~ <br /> <br />~S 1~ A~ <br />SF I~e~UO~ NO 'CO~. <br /> <br />NATER ~J:~M_Y: ~ <br />TE~T HOLE~ READY: <br /> <br />E~ISTING TANK SIZE~ <br />EX~STING DRAIN F~ELD LZNES: <br />SEPTIC TANK ~JMPED: <br /> <br /> ITEM <br />REPAIR <br /> <br /> TOTAL AE~EE~ED FEE~ <br /> PEf!%/IOJ$ RECEIPTS <br /> THIS RECEIPT <br /> <br /> BALANCE <br /> <br />PAYEE; RECEIPT NO: <br />RECEIVE0 8Y~ dw ~PE: ~ECK <br /> <br />~EE A~EO ~M~T FOR RE~IR~ OF ~-$[TE <br /> <br />THIS IS A VALID PF. RMIT x< ll~I$ g{EEMIT EXPIRE~ 360 DAYS FROM Ii~ I~YJE (3ATE. <br /> <br />REHARKS; REPAIR I;~9854 <br /> <br />0tTNALD E. ~X:X)0LEY, NAR~ON COUNTY BUILDING OFFICIAL / BY <br /> <br /> <br />