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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: 5E~-~147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />03/29/91 ]'iME: 11:10:08 <br /> <br />2005? ~RZM RD NE <br /> <br />UNITS: <br /> <br />COUNTY <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CCNYRACFOR, NO.. 3~535 <br />AF~RiCAN UNDERGRDUNDCONST. <br />PO BOX 55? <br />MOLALLA, OREC~3N g?03g <br />PHON~: 829-940? <br /> <br />31040 <br /> <br />~La~TER ,~UPPLY: <br />TE~T HOLE~ READY= <br />SiTE EVALUATION <br /> <br />~18TIN6 O~&N FIELD LtN~: <br />SEPTIC T~K ~PED: <br />PR~I~S NO. BEO~; <br /> <br /> ITEM <br />REPAIR ~ M~.dOH <br /> <br />PAYEE: <br />RECEIVED BY: CL <br /> <br />TOTAL ASSE~R~D FEE~ <br />PREylOU~ R~CEIPT~ <br />T~Z~ RECEIPT <br /> <br />A~,~CAJNI <br /> <br /> ~0.00 <br /> 80.00 <br /> $0,00 <br /> <br />BAL.N4CE DUE $0. O0 <br /> <br />RECEIP'F NO: <br /> <br /> ATTACHED DOCt.~ENT FOR -RE(~z~T~ ~OF ON"~ITE ~E <br /> T~JS 1SA V~ID ~IT * ~JS ~IT ~i~ <br />~T~TI~ FAI~ ~ ~ ~ ~ZR~ ~ STATE <br /> <br />RP-?4ARKS: NAJ'OR REPAIR R~7290 ~ ~ <br />DONALD g. ~7ODL~Y, MARION 6OJNTY 8U1LOiN~ OFFICIAL / 8Y ......................................... ~.. <br /> <br />OFFICE COPY <br /> <br /> <br />