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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, (~REGON 97301 <br /> <br /> PHONE 588-6147 <br />CODE-A-PHONE 4:30 P,M,, - 8:00 A.M. <br /> <br />peMotming wo~ on a property l ow~l or occupy,, <br /> <br /> builder. <br /> <br />R~[D~TIA <br /> <br /> 12473 FRY ro NE <br />AURORA OR 9?002 <br /> <br />12475 FRY ROAD NE <br />AURORA <br />PHONE: 678-5494 <br /> <br />SITE NUMBER: 4675 <br />VALUAT [ON: <br /> <br />45 1N EFU 6 <br /> liRFIEG LOT:: -CORN~R~ <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CCNTRACTOR, NO. <br />HERR[N, TREE~SIE <br />12475 FRY ROAD NE <br /> <br />PHONE: 878-5~94 <br /> <br />0~38099 <br /> <br />9020190 <br /> <br />AC NO NO <br /> <br />WATER SUPPLY= P~ <br />TF. ST HOLES READY: <br />SITE EVALUATION NUNSER: <br />E~ISTING TANK SIZE: 1000 <br />~D~ISTI~ DRAIN FIELD LIN~= <br /> <br /> ITE~ <br />AUTHORIZATION NOTICE <br /> <br />PAYEE: HERRZN__TRES,'*~ [ E <br />R~CEIVED BY: ~ <br /> <br />SEE TTACHED DOCUMENT <br /> <br />ALL NE~ IN~T; <br /> <br />OJ, TITY <br /> 1 <br /> <br /> ANOUNT <br /> $105.00 <br /> <br /> $305.00 <br /> $0.00 <br /> $10~,00 <br /> <br /> $0,00 <br />~CEZPT NO: 21429 <br />i ~ ~K ~: 0 <br /> <br />% R~I~ PROCESS ~ERE NE <br />~E AP~ZC, N~T TO A.~SU~ ~AT <br /> <br />REMARKS: FIELD CHECK ~t2485 <br /> <br />CITY JURISDICTION: 8Y _, <br /> <br />DATE <br /> <br />to~ ¢ ~c ,~ ~ F~FV ,~.~ O[~FICE COPY <br /> <br /> <br />