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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:588-51~7 8:0b-4:30 <br /> 24 HOUR CODE-A PHONE: 588-7904 <br /> <br /> ............ ,, <br /> <br /> AURORA OR 97002 ' ~ , j <br /> ............................................................................... d~,E~ION..COUNTY_,_ ........... NQ .................... :'~;~ o~ ~Eo~oous ' <br />U~E OF BUILDING; <br /> <br /> ~175 5TH ~'1 .............................................. <br /> HUbbARD OR 9?032 <br /> P"r-IQ,'NE; 981~307& ~.[T~ NU~ER+. ~--01~2~ <br /> VALUATi~; <br /> <br /> .................................. g.~ .................. R~ .: .................. !.~_ .~ ................... EFU <br />'WIDTH'. ?E~N: :, AR~A; "UNIT~'. ' RR~ LOT: ~CORNER: <br /> <br />TYPE,: C~N-':.~iTE ~B/'~.,GE <br /> <br />PE~I' OR APPLe. CATION NO: <br /> <br />~T~C'TOR,, NO. <br />TAU'I'FD~T ~ ~ELL <br />3175 5"~'H ~T <br />HU~BARO OR 97032 <br /> <br /> [ T~ <br /> <br />9039608 <br /> <br />WATER SUPPLYt ~,~ <br />TE~T HOLES RE~ADY': YES <br />SiTE EVALUATI~3~ NU/V~ER.- 33867 <br />PD(TSTiNG 'r/~NK SIZE-. <br />~i~TiNG ORAIN FIELD LINES: <br />,SE'P'FIC 'rANK PUMPED: <br />PREV.[0U5 NO+ DEDR~]X])ivLS: <br /> <br />4 <br /> <br />TOTAL A,SS~EO <br />PR~ViOUS R~CEIPTS <br />TH~8 RECEIPT <br /> <br />BALANCE <br /> <br />(~JAN'f i TY <br /> 1 $365.00 <br /> <br /> $365-00 <br /> $~.00 <br /> <br />SD,C0 <br /> <br />CiTY JURISOICT~0N: BY ................... OAf'g ..................... <br /> <br /> .p, AYEE: TAU'fFES..T,, RUS~L · R£CEiP'F NO: 4~59 <br /> R~OEIVEO BY: ~B ~ ~ . TYPE: CK ~ECK =: 1058 <br /> ...... ~ ................................... <br /> SEE ATTACHED ~U~ENT FOR RE~IREM~T~ OF ~-8~TE S~AG~ SY~T~. <br /> <br />~ THIS IS NOT A P~iT, ~[S ~ICATI~ ~ST ~ TH~ A R~I~ P~ ~ERE THE <br />~ING ~ST BE ~ED. IT 15 THE ~SIBiLITY ~ TH~ A~I~T TO ~ ~HAT <br />ALL N~RY XNF~Ti~ H~ BE~ ~ID~. <br /> <br /> REVI~: <br /> ......................... ..... <br /> R~RKS; 5~O ~ILTER SYS'F~ <br /> <br />OFFICE COPY <br /> <br /> <br />