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MARION COUNTY BUILDING INSPECTION <br />~F:NATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97501 <br /> <br />PHONE: 588-5147 8:00 - 4:30 <br />HOUR CODE-A-PHONE: 5~-7904 <br /> <br /> 08/09/90 <br /> <br />$~?US ^oDReS~NDAL, O,F- <br /> <br /> ?75? 5~ERNAN RO SE <br />us~,~g~&b~e OR"" 9v~25 .... <br /> <br />510 S,N ?~'H <br />:~SL,IB L & N,I l~Y OR <br /> <br />CATEGO¢~¥ <br /> <br />?~bN fFiACT CITY <br /> <br />FflARION C~JN T Y NO <br /> <br />OCCUPANCY Rg~i DEN iii <br /> <br />OCOD~ANT LOAD <br /> <br />CAMI~LLIA HE.[GH1S NO,3 <br /> <br />~AN~.LUA'T Ir)N: ZONE <br /> <br />AC NO ~E5 · <br /> <br />P~RNI3 OR AF'PLICAF1ON NO: <br /> <br />WATER SUPPLY: <br />TEST HOL~ RP~ADY.· <br />SiTE EVALUATION NUMBER: CXV,1ELLiA HEI~F <br /> <br />~iST~NG D~IN FIELD LINES= <br />SEPTIC T~K ~PED: <br /> <br /> I l EM ' ' Y <br />STANDARD ON-51 f'~ 5YS[EJ~ ~ <br /> <br />TOTAL ASS~ FEES <br />PREViOU~ RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE ODE <br /> <br /> $165.00 <br /> $165,00 <br /> $1~5.00 <br /> <br /> $o.oo <br /> <br />27845 <br />2356 <br /> <br />PAYEE.' A~DAL, D,,P. & B.J. RECEiPf' ND: <br />RECEIVED BY: Pti TYPE: CK CHECK <br /> <br />r~T~'7~-~;-;[~iY7 ~d'is *~% ~f i* ~ ........................... <br /> <br />R,~I'4ARKS: NFW 5EPl lC f~2356 <br /> <br />CiTY JURISO/CFiON= BY ......... OAI~ <br /> <br />OFFICE COPY <br /> <br /> <br />