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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. t~O. 225 <br />220 HIGH STREET NE <br /> SALEM. OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-790~ <br /> <br />SIGNATURE ~ AppLICANT .... <br /> <br /> 0ATE:: <br /> <br />Ow~TE: 09/23/91 <br /> Ko[TRE, RAY <br /> <br />mm <br /> <br /> TAX <br /> <br /> CON~TRUCYION TYPE <br /> <br /> CohcrRACT <br /> <br />_/~iON .COUNTY <br /> <br /> su~o~Wb0~= <br /> <br />AUI~VILLE, OR 9?325 <br /> <br />SECTION ' <br /> <br />TYPE: ON-SI '~E SCg~AGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CL]N [ RACTOR, NO. <br />~TT~, ~Y <br /> <br />~Vi~LE, OR g7325 <br />~E: 364-2318 <br /> <br /> SiTE NU~ER= 10216 <br /> VALUATiON: <br /> <br /> __2N AR3 <br />~RRE~, LOT:: - ~c~RNE~:: <br /> <br /> ITEM <br />S~ < ~ MOHTHS OLD <br /> <br />NATER,~UPPLY: <br />T~T HOLE5 READY= <br />SITE EVALUATION NUt4~ER: 10216 <br />~iSTiNG T~K SIZE: <br />~[~T/NG ~IN PIELD LiN~: <br />SEPTIC T~ <br /> <br />TOTAL~E, O PEE~ <br />TH[5 R~EIPT <br /> <br />~J'~OUN T <br /> $105.00 <br /> <br /> ~05,00 <br /> 105.00 <br /> $o.00 <br /> <br />DUE $0, O0 <br /> <br />PAYEE; RECEIPT NO: <br /> <br />RECEIVED BY: ¢'1 ,"' TYPE-' CHECK <br />~ ATTACHEO OC~ME. NT FO~ ~~TS O~ ~-SJT~ ~ <br /> <br />REi~ARK~: NE~ SEPIIC R~2581 FOR P~TURE R~[OENCE SiTE <br /> <br />L'YJNALD E+ I~ODLEY, ~RiON COJNTY BUIbD[N~ OFP[CIAL / ~Y <br /> <br />OFFICE COPY <br /> <br /> <br />