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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />o20 HIGH STREET NE <br /> SALEM, ORI=GON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:80 <br />24 HOUR CODE~A-PHONE: ~88-7904 <br /> <br />Ow,RATE: 05/21/90 TJ[ME~ 11:51:53 <br /> <br />OCCUPANCY <br /> <br /> 97?3 F~RTER RD <br />AUIYE~ViLLE OR 9?325 <br /> <br />CONTRACT C1¥¥:: UGB:: <br />}MARION COUNTY , <br /> <br />NO <br /> <br />360 N 11TH -PHIL ~ <br />m SWLLe, ,9" x <br />PHONE: 749-29~,5 \' / <br /> <br />~'YPE: ON-$iT~ SE~IAGE <br /> <br />PERMI1 OR APPLICA~'i(.W NO: <br /> <br />C~NTRACTOR. NO. <br />F~TZNER. RICHARD <br />360 N 11TH -R-IiL <br />AUM~VJLLE. OR <br />PHONE: 749-2945 <br /> <br />EXISTING SYSTEN EVAL. RPT. <br /> <br />25607 <br /> <br /> Sll'E NUI,~ER: 10027 <br /> VALUATiON: <br /> RANGE ZONE <br /> <br /> AC NO NO <br /> <br />WATERS UPPLy: PW <br />Tm=,T HOLE~ READY: <br />$I?E EVALUATION NUMBER: <br />~J$TING TANK SIZE= <br />EXISTING DRAIN F[ELO <br />~EPT[C T.NflK PUMPED: ~[LL ~RJNG iN <br />PRE'V[OUS NO, <br /> <br />60 <br /> <br />PAYEE: <br />R~C~IVED <br /> <br /> QUANT I TY ANY, DUN F <br /> 1 $100.00 <br />TOTAL A~ED FE~ $100.00 <br />PRIS"VIOUS RECEIPT~ $1OO,O0 <br />THiS ~ECEIPT $0~0o <br /> <br /> $o_o0 <br /> <br />REC£[P¥ NO: <br /> <br /> ................................... ~ .... TYPE,* CHECK #: <br /> ~[';E AT1ACHED OOCUM~qT FOR REqUJRE"M~.~NTS,,O~ ON.,.SZTt= ~E <br /> THIS IS A VALID PEII~IT :~ TH.T~ ~[T ~!~ 360 L~ P'RC~ IT~ I~SUE DATE. <br />(:~NSYI~CTIOM FAILS TO ~ ~ ~Z~ ~ STATE ~O <br />~i~ ~I~, ~IS ~IT ~ B~ ~ ~O ~lO. <br /> <br />RFd-2vT~kR~; LOAN <br /> A,', <br /> E, NCODLE¥, MARION COUNTY BUiLDiNG OFFICIAL / BY __~ ....................................... <br />~ALD <br /> <br />OFFICE COPY <br /> <br /> <br />