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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG- 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 /> 435 NORTH ~NTL~ H~ SE : <br />g~'fROi T OR 9?342 <br />~'O~E'b~-'~O~ ~ ................................................................ ~E'I'~i~ ......... ~ .......... ~O ........ ~ .... ~: NO. O~ '~D~bO~S <br /> <br />671'~ 14TH AVE <br /> <br />PHONE= 390~1137 <br /> <br />............................... · ......... VALgA~Of4~ .............. <br /> <br />'MAP: <br /> <br />TYPE= ON-SITE SEWAGE <br /> <br />PER,lIT OR APPLiCATION NOt 9039493 <br /> <br />CONTRACTOR, NO. 36421 <br /> <br />P O 8OX 465 <br />DETRO,t 'l', g73fl. 2-0000 <br />PHONE; <br /> <br />LSEEPAGE TRENCH <br /> <br />NATER SUPPLY; CN <br />TE%'T HOLES REAOY: <br />si'rE EVALUATION NURSER; 2905? <br />gXiSTING TANK S~ZE; <br />~j~TiNG DRAIN FIELD LINES; <br />SEPTIC T~NK PUMPED: <br />PREVIOUS NO. 8EDROONS: <br /> <br /> (,3JANTJTY <br /> q $210,00 <br />C'~/ TOTAL AE.q~E~ED FEES $2'J0.00 <br /> P~E¥IOU$ RECEIPTS $0.00 <br /> THIS RECEIPT $2!0,00 <br /> <br /> PAYEE: KFVIN'~ BACKHOE iNVO~[CE NO: 41559 <br /> RECE~VEO BY: c] ........................................ TYPEt iN CHE"CK ~= O <br /> <br />* THiS 15 NOT A PE~iT. THiS APPLI~TI~ ~ST ~ TH~ A R~ ~E~ ~ERE THE <br />P-OLL~ING ~T BE ~P~TED. iT iS THE R~I~iLITY OF THE APPOinT TO ~RE THAT <br />ALL NECE~ iNFO~T~ H~ BE~ P~DED. <br /> <br />PLAN R~¥~£~: BY'. ........................... <br /> <br />I't!~l%A RK$: P~Rt~I T <br /> <br />CATE <br /> <br />CITY JURiSDICTiON: DY DA'I~ <br /> <br />OFFICE COPY <br /> <br /> <br />