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MARION COUNTY BUILDING INSPECTION <br />SENATOR 1BLOC, 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 /> 5983 ~ALINA CO(JRT S~ CON'mAc'r ciTY ~ u~a <br /> <br />AUtCSVILLE OR 9?325 ~ <br /> ....................... -J~c~R1,ON (~)N.~Y. '' NO~ <br /> <br />:OCCUPAN1 LOAD <br /> <br /> 3 <br /> <br />IU~NER, OR 97392 <br />PHC)NC:: 743-2?23 SiTE NU~: 1058~ <br /> . YALUAT I ~ = <br /> <br />~YPE: ON~-~i IIE ~EWAGE <br /> <br />PERFFllT OR APPLIC4~TiON NO: <br /> <br />CONTRACTOR, NO. <br />STUTH~ll, RICHARD <br />6830 ~NSET <br />FUF~ER, OR 9?392 <br />~E: 743-2723 <br /> <br /> ITE~ <br />SITE EVALUATION, FI~T LOT <br /> <br />PAYEE: <br />RECEIVED ~Y: CL <br /> <br />25357 <br /> <br />HATER SUPPLY~ P~ <br />TEST HO~IEE, READY: <br />SITE EVALUATION NU~V~ER: <br />EX[~TiNG T,N4~ SIZE: <br /> <br />SEPTIC ~AN~ PUMPED: <br />PREVIOUS NO. 8~.ORO~: <br /> <br />SEE ATTACHED OOCUMSNT FOR RE~U~RE~T~ OF ON--~ITE SI~,~AGE SYSTIB~I. <br /> <br />NOT~: TRI5 I]OEG NOT GRANT OR iMPlY PE~I~ION TO ~JILD ~ ]HIS PARCEL. PI-~ING AND <br /> <br />COUNTY 8U[LO.[NG OFFICIAL / BY ...... ~ <br /> <br />OFFICE COPY <br /> <br /> <br />