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MARION COUNTY BUILDING INSPECTION <br />SENATOR 9LDG,, NO 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other ~ · <br /> <br />I h3ve read and agree o the terms stmlf~)d on the reverse side <br /> <br />105 GUY IV~RE OR <br /> <br /> OR f~7342 <br />................................... DE'TI~YIq'- ........... ~v. ,,: '"'NO ............... ~ ........... <br /> <br />PHONE: ?0?-586-3280 <br /> <br />237 . .5451D. .~E... ~ ........... NO~.~ ....... Yp.:TA- ...... <br /> <br />2 <br /> <br /> rYPEt ON-SIT~ <br /> <br />PE~'~'r OR APPLICATION NO~ <br /> <br />CONTRACTOR, NO. <br />~VAL. ~ E. <br /> <br />~TA ~, ~ g5~03 <br />~= ?0?-586-3280 <br /> <br />~[ATER SUPPLY: <br />TE~T HOLP-~ RE, AOY: <br />~iTE EWALUATION NUIV~ER: <br />~iSTING TANK <br />EXiST~N~ ORA~N <br />~E¢i'[O TANK PUMP£O~ <br />PJ~'¥IO, J~NO. BEDROOMS: 1 <br /> <br /> il~ F.~ANTITY AMOUNT <br />AUTHORIZATION NOTICE - FLD. V,l~IT 1 $105.00 <br /> <br /> : ~I~ R~IPT~ $105.00 <br /> THI~ R~EiPT <br /> <br />BALANCE DUE $0, O0 <br /> <br /> PAYE~: INVOICE NO.* <br /> R~CEIYED BY-' CL ..... TYPE: ~E~K ~: <br /> <br />~T~CTI~ P~THTOS ~ ~LL~~~i~ OF STATE ~ ~ ~l~ ~ <br />Z~l~ ~1~, i ~ ~D ~IO'. <br /> <br />REMARKS~ ~3¢.PT[O ,~¢.jI~rH ~ ,~ <br />L)QNALD E. NOODLf-Y, MARION ~NTY BUiLDiNG OFFICIAL / BY ........................................~ <br /> <br />OFFICE COPY <br /> <br /> <br />