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MARION COUNTY RUILDtNG INSPECTION <br />SENATOR BLDG. NO- 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON g7301 <br /> <br /> PHONE 588-5147 <br />CODE-A.PHONE 4:30 P.M. - $;00 A,M, <br /> <br />The work w;ll be ~e~fotmed by a re~li~*lered ~ullder. <br /> <br /> 10153 MILL CREEK RD <br />AUt~VILLE <br />'u~'bk~u'lCDl~k~: ................. <br /> <br />SE <br /> <br />OR 9'/'325 <br /> <br />................ ,[*~.iTE, ROCK ADON <br /> <br />3 <br /> <br />PHONE: 749-1279 <br /> <br /> SITE NUMBER: 9045 <br /> · VAtJJAT X ON :, <br /> · ' , ~Cf~3'N: ...... :'T-dWt~ip: ' ...... ~ ~ANaE: 'Z0~: <br /> <br /> ~.~A: ' 3~ .......~'i~s;' ' ~ ' : m~a~. ~OT~~ .... O0~; <br /> <br /> : ..... <br />......... ~ ~, -,... ....... . ....... ~,.. ,~ ...... ~, .,...._. ~' ....... iiI <br /> <br />, MAP: <br /> <br />PEJ~IlT OR APPLICATION NO: <br /> <br />CONTRACTOR. NO. <br />FULL C.-:-:-:-:-:-:-:-~PEL TABERNACLE <br /> <br />20796 <br /> <br />PHONE: 749-1279 <br /> <br /> IT1~.1 <br />AUTHORIZATION NOTICE - FLD. V~'I~.', <br /> <br />WATER SUPPLY: <br />TE'~T MOLES <br />SITE EVALUATION NUIW~ER: <br />~XSTING T~K SIZE: <br />~X~TING D~N F~ELD LIN~: <br />SEPTIC TANK ~ED~ FO~ <br /> <br />' .' THIS RECEII~F <br /> <br />(~XJANTITY AMOUNT <br /> 1 $1~5.00 <br /> <br /> $105.00 <br /> $105.00 <br /> $o.oo <br /> <br />E~AL.~OE DUE $0.00 <br /> <br />PAYEE,' .. v RECEIPT NO= <br />RECEIVED BY: ~b , -. ,, ,'. ," '. ' · · TYPE: · CHECK <br />SEE ATTACHED DOCUMENT FOR RE~RI~T~ OJ='0~'-SITE SEWAGE 's,Y~TEN. <br /> <br />REHARK~: AUTH <br /> <br />0CNALO E. ~)OOLLS', MARION C(~NTY 8U'rLOXNG OFFICI4~ / BY <br /> <br /> <br />