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MARION COUNTY ~BUILDING INSPECTION
<br />sEN'ATOm BLOG. NO, 22S
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE 588-5147
<br />CODE.A-PHONE 4:30 RM. - 8:00 A,M,
<br />
<br />6054 PLUM TREE cT NE
<br />KEIZER OR 9?303
<br />PHONE= 393-3512
<br />
<br /> 3:2 6S
<br />356 163'/60 · ~F
<br />
<br />~UCT~ TYPE;
<br />
<br />74110-000
<br />
<br />C~EOC~Y: RS$iDENTiI
<br />
<br />:'CONTp,~,~O~¥: UGB:
<br />MARICN C4XJNTY NO
<br />
<br />THE I~NCH
<br />
<br />SITE NUIVEJER; 7681
<br />VALUATION:
<br />
<br /> lid AR
<br /> NO
<br />
<br />MAP:
<br />
<br />TYPE: ON-SITE
<br />
<br />PERNIT OR APPLICATION NO: 16969
<br />
<br />CONTP. ACTOR. NO ..... ..~.. ............
<br />APELTAUER, MILAN &
<br />6054 PLUM TREE CT NE .
<br />KEIZER OR 97303
<br />;>HONE; 393-3512 ,",!"?""
<br />
<br /> HATER .¢AJPPLY: PtN
<br /> TEST HOLES READY:
<br /> SITE EVALUATION NUI"~ER= THE RANCH
<br /> EXISTING TANK SIZE:
<br />.. EX.Is,,T,,I~NG ,,,.DI:,~A I,N. E,.i[.EgZ) LIN~ ~.
<br />SEPTIC TANK PUMPED: "%
<br /> PREVICUS NO. 8EDROOI4S:
<br />
<br /> ITEN ..... ' .... 'QUANTITY AIvOJNT
<br />ST~DARD C~-SITE SYSTEM .... ":~. ','."-".'" .'.~;..-". ........... c'-...,.,:".,..:.-~ .......... 1 $165.00
<br /> , .%.~'r.; ~, .: .... ,,' ,<,, ;' .......
<br /> "' "'~ '.'' ',.',Y.' '~F ~""" ' "~ ' ' '
<br /> ,,,~, ,¢,,,,,41~,,,~ ~,,,u,,,,., ~'e~,,;4~ ,~*~,.$~ 65. co
<br /> .. *~ mc ,.,:...,..: .¢.:~.~,,.¢RE?tO~¢ l:~i~t'#TE, . $165. CO
<br />
<br /> ~:.,~ .,t:~[¢~?.; ~,'-.~.-.:......,...:.~.,~:. =;-,:..:;~..*, ;.~'.,y,~,~:,;;,!,,.,,,,,,~
<br />RECEIVED
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<br />~T[~ FA[~ TO ~~~.~ ~
<br />
<br />NO;
<br />
<br />[,T~ I~SIJ£ DATE. IF
<br />IKARION COUN~ ~ILDI~
<br />
<br />R'8'AARK~ NE~; SEPTIC f~;'/'/65 .. , ~,.!: ;", ,: ir ,
<br />[X)NALD E. HOODLEY. MARION COUNTY BUI'LDING 'OFFICIAL / 8Y
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<br />¢¢~#~s.~ ~v,n,~ OFFICt~ COPY
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