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MARION COUNTY BUILDING INSPECTION <br />SENATOR EILOG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM. OREGON 97301 <br /> <br /> PHONE: 588t-5147 1~:00 - 4:30 <br />24 HOUR CODE-A-PHONE: <br /> <br />LOT= <br /> <br />UNKN~ ~ <br /> <br /> ~08~2 OL~TEAO RO <br />AJJRORA <br /> <br />PHONE: 878-58@8 <br /> <br />OR 97002 <br /> <br />NE <br /> <br />: OCCUPANT LOAD <br /> <br />SI l"~ NUFIBER: 9677 <br />.. VALUAT [QN: <br />RANGE ZONe: <br /> <br />2.4~ .... AC ~ NO_:, ....... NO <br /> <br /> ON-SITE SEWAGE <br />PERMIT OR APPLiCAIICN NO: <br /> <br />9034766 <br /> <br />WATER ,%JPPLY: PW <br />T~ST HOLF_5 REAOY: <br />SITE EVALUATION NUt,~ER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD <br /> <br />IrE~ QU~NTITY <br />REPAIR - MAJOR 1 <br /> <br />TOTA~ A,%SEl~.~ED FEEB <br />THIS RECEIPT <br /> <br />BAI.~E [,3JE <br /> <br />PAYEE: R(,JSINSON, RANDY & SU~AN RECEIPT NO: <br />RECEiVEO ~Yt ~ TYPE= CK C~ECK <br />3RE AT"FACHEO DOCUN~[NF FOR REi~UiREMENT3 <br /> <br /> ANOJN I <br /> $80.00 <br /> <br /> $80. O0 <br /> $o_oo <br /> <br /> $0.00 <br /> <br />36656 <br />2444 <br /> <br />R~J'qAR~: ~ REPAiR/REPLACEMENT R-6g?8 <br /> <br />CiTY JURISDiCTiON: BY <br /> <br />0AFE <br /> <br />~o.u # ~c ~s.,~ ~'v ~ OFFICE COPY <br /> <br /> <br />