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MARION COUNTY bUILDING ~NE~PECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE; 588-5147 S:O0 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />BU ]'LER, ~V[0 <br /> <br />~^× ~0~ <br /> <br />RE~iDENTiI <br /> <br />9978 STAYTON F~DAD E~E <br /> <br />:t~IARI ON COUNTY: <br /> <br />PHONE= 769-7822 <br /> <br /> 18 <br /> <br />P~RMI~ OR APPLiCATiON NO: 36804 <br /> <br />CONTRACTOR, No~ <br />~UTLER, DAVID <br /> <br /> 769-5503 <br />PHONE: 769-7822 <br /> <br />TEST HOLES READY: <br />SITE EVALUATION NU~V~ER-" <br />EXISTING TANK <br />~I~TING O~iN FIELD LIN~: <br />~TiC T~K ~: <br /> <br />iT~4 <br /> <br />QUANT I TY <br /> <br />THi~ RECEIPT <br />BALANCE <br /> <br />AJl,IOUNT <br /> $8§. 00 <br /> <br /> $85. O0 <br /> $85.00 <br /> $0 <br /> <br />$0.00 <br /> <br />PAY~; <br /> <br />SEE ATTACHEJ3 DOCUMENT P~3R <br /> <br />* THIS l~ A V~lO ~IT ~ THIS ~IT ~l~ 360 ~ F~ I~ I~E ~TE. IF <br /> <br />RERAR~; REPAIR R--3918 NEW HOUSE & SEPTIC R~PLACING EXISTING <br /> <br />CONALD E, WOODLE¥, MARION COJNTY BUILDING OFFICIAL / 8¥ <br /> <br /> OFFICE COPY <br />ORM # MC 15~56 REV 4~O <br /> <br /> <br />