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MARION COUNTY BUILDING INSPECTION <br />SENATOR SLDG~ NO. 225 <br />220 HIOH STREET NE <br /> SALI=M, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />$tGN^TURE OF APPLICANT::. <br /> <br />RE'S1 DEN1 i~ <br /> <br /> 8612 ,SHAW ,~,~.IARE RD AE CONTRAC, T C, tTY;: : UG~ : ~UPANY gOAD: <br /> <br />Au~viLLE OR 97325 <br /> .................................... ~t-~tY- ............ N~ ......... T.o o~ ~l~.s <br /> <br />8613 Ii'lAN ,S~]UARE RD SE <br />AUMSVILLE, OR 9?325 <br />oHC~E: 36,~-2318 <br /> <br />:: sUe0ivlsl~ 3 <br /> <br />SiTE NUN~ER: 10216 <br />. VALUATION: ..... <br /> <br />AREA:; "~ ~' ;UNITS 8~' : m~EG LO"t~ 2t4 - CO~N'~R," AR3 <br /> <br />~9 <br /> <br />IYPE: C~-~iI'E SELVAGE <br /> <br />P~RNll OR APPLiCATiCR NO: 34363 <br /> <br />L~',IrRAO'FOR, NO_ <br />KO1TRE, RAY <br />8613 SHAW f~XJARE RD SE <br />AUMSVILLE, OR 97325 <br />FI-lONE; 364-2318 <br /> <br />~ATER ,~UPPLYt P~I <br />"rEST HOL~ READY: YES <br />SiTE EVALUATION NUiV~ER: <br />EXISTING rA~K SIZE: <br />~D<i~TiNG DRAIN FIELD LIN~= <br />~EPTIC ~K ~MPED: <br />PRiZeS NO. BEO~ <br /> <br />$175.00 <br /> <br />~175.00 <br /> 175_00 <br /> $0.00 <br /> <br /> (,1JANfl'[Y <br /> ~ll'E EVALUATION, FlRf~I LOT 1 <br /> <br /> ~H[$ RECEIPT <br /> :BALANCE DUE $o.oo <br /> <br /> PAYE~; RECEIP~ NO: <br /> RECEIVED BY: mi TYPE: L~clECK <br /> <br /> 5~ A~IA~ED ~M~T flOR RE. fReTS OF ~ITE 5~E <br /> <br />~ST~I~ FA/~ TO~ ~L~I~~STATE~D~I~ ~TY~ILDI~O <br /> <br />REMARKS: 511E [VAL ~250~ SlO SY~IEM /'~[} <br />LX~IALO E, HOCOLEY, FLARiON COUNTY BUILDING OFFICIAL / 8Y ...........................................~ <br /> <br />~o~ # MC ~-~ ~ ~ OFFICE COPY <br /> <br /> <br />