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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOC, NO, 225 <br />220 HIGH STREET NE <br /> IAL~M~ OREGON 97:301 <br /> <br /> PHONE: 5~-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a re~tiste~ed builder OR ( ) the authorized repcesenlative <br />of a registered buiIder, <br /> <br />Other <br /> <br /> 11371 FARGO RD NE <br />,NJROP, A, OR g?0D2 <br /> <br />~IGNAT~F~E OF APPL CANT: ................................... <br /> DATE; .................................... <br /> <br />~175 5TH <br />HUBBARD OR 9703'2. <br />PHONE; 981-3074 SITE NUt. ER: 92-01622 <br /> VALUAT tON: <br /> <br /> 2.75 J ~ ~ NO i NO <br /> <br />4 <br /> <br />PER~IT OR APPLICATION NO: 99608 <br /> <br />C~NTRAC'roR; NO; <br />'rAUTFE~T. RU~ELL <br />3175 5TH IT <br />HUAffiARD OR 97032 <br />PHCW, E~ 9~1-307a <br /> <br />HATER E, UPPLY.' P'~ <br />'II~T ~_ES RF_~Oy: YE~ <br /> <br />~[STING T~K SIZE: <br />~ISTI~ D~iN FIELD LINE~: <br />S~TI~ T~K ~0: <br /> <br /> ITEhl (~JANTITY /VC~UNT <br />SAND FILTER 1 $3B5.00 <br /> <br /> ?OTALA,~S~SED ,FEE~ $365.00 <br /> PRE~i~5, R~IPT5 $365.00 <br /> <br />SO.U0 <br /> <br />PAYEE: RE(~E[PT NOt <br />RECEIVED BY: P8 TYPE: CHECK =: 0 <br /> <br /> SEE ATTACH~O 00CUMENT FOR RE(~JiREI~IE~,ITS OF ~iTE ~AGE ~T~. <br /> <br />Z~/NG ~l~, ~1S ~17 ~k B~ ~ ~D VOID., , <br /> <br />R~kRF~.S: SAND FILTER <br /> <br />DONALD E, 9~DODLEY, MARION C~JNTY BUiLDiNG OFFICIAL / 8Y <br /> <br />¢OR~ ~ ~, ~-~ ~v, ~ OFFICE COPY <br /> <br /> <br />