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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 5~-5147 8:00 - 4:3,0 <br /> <br />The work w~lJ be Deffotmeo by a registered builder <br /> <br />~OX. ~[~AEL G & L[N~ L ~ <br /> <br />CA'~EGORY <br /> <br />OCCUPANCY:: <br /> <br /> 6591 ~ETER:~ ROAD ~E CONTRACT CITY:; UG~ <br /> <br />AUh'~V I LLE OR 97325 <br /> ................. ~R[~ ~N'TY "NO' <br /> <br />2 <br /> <br />10965 JAl~.~ W~y DRIVE <br />AUI',~V[LLE g7325 <br />PHQNE: 749-2155 <br /> <br />SE <br /> <br /> SITE NUMBER: 9586 <br /> VALUATION.: <br /> <br /> 1,9 ~ 1W AR <br /> ?. ~ Y~ NO <br /> <br />[YPE: CN-$I3E SE~/~G~ <br /> <br />PERMIT OR APPLICATION NO: 9029~27 <br /> <br />CONTRACTOR, NO. <br />MMOX MtC,~IA~L G ~ I.[NOA L <br /> <br />~iLLE 97325 <br />~E~ 7~g-2155 <br /> <br />WATER E, UPPLY= <br />TE3~T hOl~ READY~ <br />~ITE EVALUAT[I~ NUiV~ER: 22305 <br />E~XI~TING TANK SIZe: <br />EXiSTiNG DRAIN FIELD LiNE3~: <br />~PTIC TANK PUMPED: <br />PREViOJ~ NO. <br /> <br /> iT~ (~XJANTITY AMOJNT <br /> <br />  / PR~I~ R~EIPTS $0.00 <br /> THIS ~EIPT $165,00 <br /> <br /> PAY~: ~ MIDOL ~ ~ LiN~ L ~ ~O~IPT NO: 30785 <br /> R~CEIVED ~y:~2 ................................. .~ TYP~ OK ~ECK ~: 2901 <br /> <br /> SEE ATT~ED ~M~T FOR ~ZR~rS OF ~lTE S~E <br />* ~ ~3 ~T A ~[T+ TH[S AP~T~ ~T ~ TH~ A R~[~ P~ ~ERE THE <br />~L~[~ ~T BE ~ETE0. IT l~ THE R~IBiLI~ ~ THE AP~i~T TO ~RE T~T <br />~L N~ IN~Ti~ ~ ~E~ <br /> <br />REMARKS: STNO 5YSTFS~ R'4:4728 <br /> <br />CiTY JURISDtCII(,~: BY ....... DArE ....... <br /> <br />OFFICECOPY <br /> <br /> <br />