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MARION COUNTY BUILDING iNSPECTiON <br />SENATOR BL. DG NO 225 <br />'>20 H~GH -~TREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE,', 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE 588-7904 <br /> <br />10/23790 <br />N[CI~OL, GL.~.~N E. 56363-000 <br /> <br />842:0 HOL/V~IST RO ~ <br /> D4ARiON CCAJN"I Y NO <br /> <br />Aur,~:SV [ LLE, OR 9?325 <br /> <br />9028240/(~} <br /> <br />VALUATION: <br /> <br /> lW AR <br /> <br />~A'I"ERSUPPLY: <br />T~r HOLES RE&DY: <br />$]T~ 6VALUATION NUIV~Rt <br />EX~ST[NG TANK <br />~iSTING OP-!AiN F~ELD LiN~: <br /> <br />PRE~/'IOUS NO. <br /> <br /> ~E~IDP~TIA <br /> <br />OCCUPANY LOAD <br /> <br /> 2 <br /> <br /> i 'f <br />PR~"~RE I) l~ f'~'~ieU ! ION <br /> <br /> (~JANT'[fY A~flO. JNf <br /> <br />TOTAL AS~ED FEE~ $1~5.o0 <br />THIS RFJCEiP~ $165_00 <br />~A~CE ~E $O_0o <br /> <br /> PAYS'E: N[CHO~, GLEN ~, RE-CEIP1 NO: 29840 <br /> R~-CBiVED ~Y: gl TYPE: CK ~ECK ~: 151 <br /> <br />~ THl~ I~ NOT A PE~iT. THIS ~I~Ti~ ~ST ~ TH~ A REVI~ P~ ~E~ THE <br />FOLg~iNG ~ST BE ~L~TED. IT ~ THE ~I~]LITY OF THE ~PLiC~T TO ~RE THAT <br />ALL N~RY IN~TI~ H~ ~E~ ~IPED. <br /> <br /> OFFtCE COPY <br />FORM # M~ 15-58 REV. <br /> <br /> <br />