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MARION COUNTY~ BUILOING iNSPECTION <br />SENATOR BLDG. NO 225 <br />220 HIGH STREET NE <br /> SALEM. OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:;)0 P.M. - 8:00 A..M.. <br /> <br />SIGNATURE OF APPLI~NT <br /> <br /> OATE:: <br /> <br />owi~'E .' 10/25/89 TINE= 2:00=34p <br />s~Tus ~oo.~,~.RRY. VERNON <br /> <br />CONSTRU(;T~O N ~,~=4'086 <br /> <br />occup^Nc¥ RESIDENTIAl <br /> <br />12103 FRY ~D <br /> <br />.o~_ ~?~Q~ ................ <br /> MARION C(~JNTY Nb <br /> <br />PHONE: 678-284-1 <br /> <br /> SITE NUMBER: 8603 <br />SECTION:: TOw~$,l~=.: "~A?V~!~JATIC~: ZONE <br /> <br />8 <br /> <br />TYPE= ON"-~ITE ~EWA6iE <br /> <br />PERffi[T OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />PERRY, VElbON <br /> <br />PHONE~ 678-2841 <br /> <br />18581 <br /> <br />NATER E~JPPLY*. PW <br />TEST HOLES READY: <br />SITE EVALUATION NUI~BER: <br />EXIST)[NG TANK 8[ZE: <br />EXISTING DRAIN FIELD LINES= <br />SEPTIC TANK PUNPED.- 2/8/89 <br />P~EVIOUS NO. OEDROONS: <br /> <br /> ITEM <br />AUTHORIZATION NOTICE ~ FLD. VISIT <br /> <br />PAYEE: <br />RECEIVED 8Y~ P~ <br /> <br />TOTAL ~ FEES <br /> <br />$~ ~E <br /> <br />3"YPE~ <br /> <br />(~J,N~TITY <br /> 1 <br /> <br />RECEIPT NO= <br />CHECK <br /> <br />~NvJOUNT <br /> $]05+00 <br /> <br /> $105. O0 <br /> $105.00 <br /> $0.Oo <br /> <br /> $o.oo <br /> <br />SEE ATTACHED OO0.ff4ENT FOR RE~IREI~TS OF ON-SIT~ <br /> <br />RFJV~ARK~. AUTH -FIELD CHECK <br /> <br />DONALD E. (NOODLE-Y, ~ION COUNT~ BUILDING OFFICIAL / 8Y <br /> <br />OFFICE COPY <br /> <br /> <br />