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~;"~;M'~J~i~)'l~ 'COUNTY BUIL'DING INSPECTION <br />.... ~'~, , SENATOR BLDG. NO. <br /> · ' 220 HIGH ~TRE~T NE <br /> ~',ALEM..OREGON B7301 <br /> <br /> PHONE '~1~47 <br /> <br />FowDA'['~_:_ 05Z21:)Y.i~ ii_..._ , .... <br /> <br />8;)OZE, KENNE]I-I & JUDI'l]-! <br /> <br /> 40287-000 <br />~muo,To~'m ................ <br /> <br />10236 MAT'I'HI'EU LANE NE <br />~"(ON(~. 6?8 ~218 S[~ NU~z 4307 <br /> <br />8227 <br /> <br />NATES'SUPPLY: PN <br />TEST HOI. E~ READY~ <br />SITE EVALUATION <br />EXISTING TANK SIZE: <br />EXISTING DRAZN.FZELD <br />SEPTIC TANK I:t.k%~ED: NO/GAVE <br />Pf~'EVIOUSNO. BEDR~: <br /> <br />TYPE: ON-SITE SE~IAGE <br />pERMIT OR APPLICATION NO= <br /> <br />CONTRACTOR. NO. <br />800ZE, KENNETH & JUDITH <br />10235 ~ATTHIEU LANE NE <br />AURORA, 97002 <br />PHCt4E: 678-5218 <br /> <br /> ITE~I (~UANTITY N~O. JNT <br /> AUTHORIZATION NOTICE - FLO. VISIT ,~ I $105.00 <br /> <br /> $105.00 <br /> ,~. $105. oo <br /> = ~.,, $o.o0 <br /> <br /> $0. O0 <br /> PAYEE: , <br /> NO: <br /> RiEICEIVED BY.' pb CHECK ~= <br /> <br /> * ~ZS IS A V~ID ~IT * ~ I~E ~TE. ZF <br /> ~TI~ FAI~ TO ~ ALL ~ ~D ~l~ ~ ~I~I~ ~D <br /> z~I~ ~I~. ~IS ~IT <br /> <br />I,, <br /> <br /> <br />