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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97:301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24, HOUR CODE-A-PHONE: 588-7904 <br /> <br />oA'r~-: o7/18./.90, riME: ,,,,3,~ L! 1:2C <br /> S~N I Z.L,E,R, CON <br /> <br />DENT <br /> <br />AUM~V~LLE <br /> <br />PERMI'I OR APPLtCAItON NO: 25~80 <br /> <br />8354 GOLP CLUB RD SE <br />~:YJBLiNI'fY, OR~ 9?385 <br />PHONE~ <br /> <br /> SITE <br /> VALUAT,[ ON: <br /> <br /> gS <br /> <br /> AC <br /> <br />~A FE.R ,t~J PPLY .' <br />T~"r HOL~5 READY: <br />SITE EVALUATION NtJ~8~R~. <br />EXISTING T/~4K <br />EX.[STiNG ORA,IN F,~ELD LrNE~-* <br />SEPTIC TANK <br />P~E¥1r.~JS NO~ BEOK~DD~ <br /> <br /> 1 TEM ' <br /> RkPAiR ,,-, ~JOR 1 $80.00 <br /> <br /> TOTAL ~E~SEO FEE~ $80. O0 <br /> PR~I~S RECEiPI'~ $80.00 <br /> <br /> 8A~CE ~8 $0. O0 <br /> <br /> PAYEE: REC~[P ~ NO~ <br /> f<~C~iVEO F~Y: CL TYPE: ~ECK ~: 0 <br /> <br /> LSE~ AT1AGHED ~MENI ~OR REdiReCTS'OF ~iT~ $~E SYSTEM, <br /> <br />~ THIS IS A VALID PE~IT ~¢::-THIS PE~IT ~i~ 360 ~ F~ iTS I~E ~TE. iF <br />~ST~Cf,~ FAIO TO "~T ALL ~%~ OF' ~TATE ~ ~O ~Ri~ ~TY BUiLDiNG ~O <br />Z~iNG 0RDIN~C~, 7HIS ~IT ~LL ~D VOID. <br /> <br />(72NAbD g. ~JOOL. EY, MARjO~COUNFY BUILDING O?FiCiAL / BY ...................................~ <br /> <br />OFFICE COPY <br /> <br /> <br />