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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG_ NO. 225 <br />220 HIGH STREL~I' NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 58~-51~.7 <br />CODE-A-PHONE 4 30 P,M - 8 00 A.M <br /> <br />TIME: <br /> <br />TAX LOT <br /> <br />~'m~on~ ~ I DFJ <br /> <br /> 1310;~ ARNDT ~ <br />AURORA OR 97002 <br /> <br />NE <br /> <br />PHCNE: 678-5158 <br /> <br />SITE ~ER: 6250 <br />VALUATION: <br /> <br />~K <br /> <br />TYPE~ L'2?!-E-___~J~. ~E~..~A_~_~ <br />PER,lIT OR APPLIPATI(~I NO: <br />CONTRACTOR, NO. <br /> <br />I:'HONE .~ 678-515B <br /> <br /> ITE~ <br />8T~DARO ON-S~TE SY~TEN <br /> <br />13751 <br /> <br />TEST HOLES READY: <br />SITE EVALUATION ~ER= ~E ~I~O <br />~I~I~ T~K SIZE: <br /> <br />~IC T~K <br /> <br />TOTAL A.~;E..L~ED FEE~ <br />A~EVI~XJG RECEIPT~ <br />THIS RECEIPT <br /> <br />~JANTITY A~[XJNT <br /> 1 $165.00 <br /> <br /> $755.00 <br /> $165.00 <br /> $0.00 <br /> <br />DUE <br /> <br />PAYEE: R~IPT NO: <br />RECEIVED EY: <br /> <br />Slate ......................................... ATTenD ~T ~ ~~ ~ ~[~ ~ ~T~- '' .......... <br />r- .... : - .............. .......... <br />~TZ FA ~ ~[R~m ~ ~ATE ~ ~O X Z Z~ ~D <br />Z~ING ~I~, ~iS ~IT ~ B~ ~ ~D ~ID. <br /> <br />R'EN~Rf~: STD SY~TE~I R:F~359 FOR ~ <br />DO~iALD E. N:~/7~"Y, NA~Z(~ CO~FfY BUILDING OFFICIAL / BY ___~ ....... <br /> <br />,~,.~ * ~c ~-~ .c~ n~ OFFICE COPY <br /> <br /> <br />