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MARION COUNTY BUILDING INSPECTION <br />SENATOR BI~DG, 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 />...... DA'TE=.O.5/20/~2, .Z,[~E;.,.~5,:,231~ ......................................................................... <br />· OWNER: TAX LOT; i CATEGORY: <br /> LEA, HARVEY RESIOEN'I <br /> <br /> 10~58 N[LL CREEK r-~AD <br />AUC.~VILLE <br /> <br />USE OF BUILDI~G; <br /> <br />' DEPT~: <br />12? <br /> <br /> CH-SiTE ~E1NAGE <br />~ERHIT OR APPLICATION NO: <br /> <br />r,Y.~'r~qAC'I'OR, NO. HARVEY <br /> <br /> OR 97325 <br />.............................................. i .......... ,N_.O_ ....................... <br /> <br /> ................................................ ,'~; ;~,Ei~'N~- ........................... '~ <br /> <br /> ~ITE NUFECER: 92~01922 VALUAT ! C~: <br /> <br /> 31 8S : lW, P~, 48 <br /> ............................~Re*: . ~i+~: ........ i ihh~: C6'~; ........ ~'c'~'~.~: ..... ...... <br /> 352 : SF.: YES NO <br /> <br />NA'fERSUPPLY= N <br />· rEST HOLES READY: <br />SiTE EYALUATiON NUIVSER: <br />EXI~'rING 'rANK 51ZE: <br /> <br />SEP'FIC TANK PUMPED: <br /> <br /> AL$'r~oRIZA'rZoN NOTICE FLD. ViSiT ,~ ./~.,. , OUANTI't'Y <br /> ~' 'TH~S RECEIPT · <br /> ~ALANC~ DUE <br /> PAYEE: N ~ M OONS'fRUCTION RECEIPI' NO: <br /> RECEIVEO <br /> <br /> SEE AT/"AO~ED <br /> <br />~ TH[~ [~ NOT A P~[T. THZS APPE[~TZ~ ~T ~ TH~ A R~[~ P~E~ ~ERE THE <br />FOLL~ZNG ~ST BE ~LETEO. ZT ~ THE RES~[BJL[TY O¢ THE APPL[~T TO ~RE THAT <br />ALL N~ iN¢O~TI~ <br /> <br /> AMOUNT <br /> <br /> $~o.oo <br /> $0.00 <br /> <br />42153 <br /> <br />IC. TION: ................... <br /> <br />DA'rE <br /> <br />~ ~ MC t 6.~ ~V, 4~ OFFICE COPY <br /> <br /> <br />