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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NQ. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4;30 PM.. - 8 i00 AiiMi <br /> <br />(~v~.~.T E: 10/12/89 TTNE; 4.~ 19:45p <br />s~s Aoo~EssPERRY, VERNON <br /> <br />12103 FRY ROAD NE <br /> oR 97002 <br /> <br /> CONS ~R UC?I~N T'f PE:: <br /> <br />Iv~RI 0~ COUNTY NO <br /> <br />occur*Nc'* = RESIDENTIA <br /> <br />PHONE: 678-2941 <br /> <br /> SITE NUMBERz <br />R^NGgALUAT ION: ZONE <br /> <br />i nflnnn <br /> <br />EFU <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERi, IT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />PERRY, VERNON <br /> <br />PHONE: 678-2841 <br /> <br />9O19581 <br /> <br />NATERE~JPPLY: <br />TEST HOLF.~ READY: <br />SITE EVALUATION NUNSER: <br />EXISTING TANK SIZE: <br />EXISTING DP, AIN FIELD L[NE~: <br />SEPTIC TANK F~JMPED: 2/9/89 <br />PREVIOdS NO. <br /> <br /> ITEM <br />AUTHORIZATION NOTICE - FLD. VISIT <br /> <br />PAYEE: PERRY, VEF~ON <br />RECEIVED BY: ~ <br /> <br />TOTAL A"~SE~SED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />OUANTITY <br /> 1 <br /> <br /> :,::RECEIPT NO: <br />TYPE: CA CHECK <br /> <br /> AMOUNT <br /> $105,00 <br /> <br /> $105.00 <br /> $0,00 <br /> $'106,00 <br /> <br /> $0.00 <br />20788 <br /> <br />FOLLOWING NUST 8E CQNPLETED.:' ~I'T. T~':." RE~P(SNS;[BILiTY' OF THE APPLIC~qT TO A..~URE THAT <br />ALL NECIE~;~..%e~f INFOI:~ATION H~S .BEEN' PRO~ID~13. <br /> <br />PLAN REVIEW: BY .... DATE _ <br />REJV~RKS: AUTH -FIELD CHECK ,~1~7199 <br /> <br />CITY JURISDICTION: BY ...... DATE <br /> <br /> <br />