|
MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG, NO. 225
<br />220 NiGH STREFT NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE: 588-5147 8:00 - 4:$0
<br />24 HOUR CODE-A-PHONE: 588-7904
<br />
<br /> Other = : . .....
<br />
<br /> ~,~ -- -- --------- ................................................. ~-~ ................................ ;'cxf~6,,: .....
<br />
<br /> _,,,,'~ ................................ ~ ...............................
<br />
<br />.................................................................................= U*~L,.~ *~o.~SS, F~6~;~ ~i~'~ .....................................................
<br /> SA~ ~-,, ......................................... ,
<br /> PHONE; 749-~214 { SITE H~ER: 94~519
<br />
<br />..................... , ...................... ~ ......... ~ .............. ~ .................. 4 ..................... J
<br />I . ~ NO NO
<br />
<br /> ~PE~ OH~ITE ~E WATE~ SUPPLY'
<br /> TEST HOLES READY:
<br /> PERHZT Ok APPLICATION NO= 9859968 SITE EVALUATION NUHBE~:
<br /> EX~STIN~ TANK SIZE=
<br /> CONTRACTOR, NO. EXISTING ~RAZH FZE~D
<br /> COOK= A~NOCD ~EPTIC TANK PUHPED.
<br />
<br /> PHONE: 7~9-2214 .
<br />
<br /> IT~ .... :"' - ' · ' ' '-."" ,' , . QUANTITY AHOUNT
<br /> ANNUAL EVAL. - TEHP OR,'HDSHP.'~H' ' :"~' '~. -':-.~.
<br /> ' ' "," ' .... '" ' ', ": ,OT~' ~'ESBED'~FE~
<br /> . .': ,' .. '.' ,4' ':.'~" ',". '",,.:..'.~US .,'~EOE~PTS ,'~ f
<br /> "::' ',:,'d · , .,
<br /> PAYEE: COOK, ARNOLD - ~ra~"~r~, pl~,~ ' ~:''' :'
<br /> B~' ,,, RECEIPT NO: 6256~
<br /> RECEIVED BY= c] ..... :'".' ..... · ...... ' '"" ' ""
<br /> ................. ::," ...... ': ..... TYPE: ~n CHECK ~:
<br /> ................ :::::=:~=~;~=~==~?==.._~g_: ...............................
<br /> SEE ATTACHE~ DOCUHENT EOE~RE~U~REH~T~;,~?.~S~TE.... ~EWA~E SYBTE~.
<br />
<br /> ~p~L~M~T D~ COHPLE[ED??.':~'t'~'.~]Z~L.:~HE~"~':.~'~SP~NS~Z~Z'Ty.'oF. THE ~PPLIC~NT TO nSDURE
<br /> m.L NECES~Y ZNFORHRTZON' H~S".~N ~D'~.DED~
<br /> TM .':' ~..:. ] ..: .. :' :.' :..
<br /> ::.:,,,.:....,., ?.., ,...= ?.; ; ,..'/...','.',:',.'j ,,,~:;::.., ..,'
<br /> PLAN ~EVIE~; DY DATE C~TY JURiSDICTiON= BY DATE
<br />
<br /> ........... . ,..:
<br />
<br />OFFICE COPY
<br />
<br />
<br />
|