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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO,, :>25 <br />220 HIGH STREET NE <br /> SALEM= OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4I;30 <br />24 HOUR cODE-A-PHONE: 588-7904 <br /> <br />owf~gW E: 11/0'7/90 T IWlE: <br /> <br /> LEi OMAN, CLYD~ <br /> <br />~.0672'/-000 <br /> <br />CATEGORY <br /> <br /> )5066 SRO ~r NE <br />AURORA OR 97002 <br /> <br />~ON~RACT CITY <br /> <br />NO <br /> <br /> f-~ONE: 682-1783 <br />LOT BLOCK <br /> <br />SI']'~ NUIV~ER: t 36(51 <br />RA~LUAT ION: , ZONE <br /> <br />MAp <br /> <br />12 i UN,TS <br /> <br />YS~ · NO <br /> <br />FYPE: ~-~i)E ~AGE <br /> <br />P~l[ OR APPL/CAIIC~ NO: G028592 <br /> <br />C~IRACIOR, NO. <br />L.~ ~ DMa, N, CLYDE <br /> <br />PH~E: 68~1,,83 <br />11 EM <br /> <br />PAYEE: <br /> <br />WAIER,~JPPLY: ~W <br />TE,$I HOLER:-5 RNADY: <br />$i1'8 EVALUATICN NU~ER= 85-618 <br />EXISTING TANK $[ZE~ <br />~ISTiNG ~iN FIELD LIN~-5- <br />SEPTIC TANK ~MP6D: <br />PRE~I~S NO. 8ED~: <br /> <br />TOTAL ,r~S,.,~.~D <br />PRb~/IOU$ RECEIPTS <br />THiS RECEIPT <br /> <br />(j~JAN l ITY <br /> 1 <br /> <br /> iN¥~ICE NO: <br />TYPE= [N CHECK <br /> <br /> $1b~.Oo <br /> $0.0o <br /> <br /> SrJ,CO <br /> <br />302 ) 1 <br /> 0 <br /> <br /> 5gg AIIACHED DOCUM'~N7 FOR RPJQUIREMENT~ OF ON-SITg SPZc~AGE $Y~I~M. <br /> <br />~ FHIS I~ NOT A P£R~iT. THIS APPLICATION ~UST GO THROUGH A REVieW PROC~ ~HER~ THE <br />FOLLO~ING MUST B~ ~PLETED. I-r l$ TH~ R~SPONSISiLITY OF THE APplICANT [0 ASSURE THAT <br />ALE N~¢E~SARY INFO~IATION HAS SEEN PROVIDED+ <br /> <br />CitY JURI$0ICFiO~ 8Y OATE_ <br /> <br />~o.~ ~ ~c ~s-s~ R~v .~ OFFfCE COPY <br /> <br /> <br />