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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLIDG. NO. <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 />I em a ~e§istered builder OR ( ) t he authorized representative <br />The woFk will be pedormed by e registeted builder, <br /> <br />9550 8AT~ ~0 SE : : <br /> <br />~ BOX B23 : <br />S'FAYTON 9?383 <br />PHONE: 769--2874 <br /> <br /> ;'".."v'.".:"'"'%':~ .......... ,.,.~ .......... ,, ~;.-.-T ~ .............. ~ ........ ~C-" .......... : ...... .'-.'-Nf~~ ....... ~' .... <br /> <br />'I'YPE~ ON-SiTE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: . 39389 <br /> <br />CON'rr,~CTOR; NO. <br />8E'fHEL, OARRBLL <br />~ BOX <br />~TAYTCN 97383 <br />PHONE: 769-2874 · <br /> <br />WAI'ER,~JPPLY: PH <br />T~T HOLE~ READY: <br />SiTE E'VALUATION NUMBER= 83~1948 <br />E,h<I~TING TANK SIZE: <br />EXISTING D~iN FIELD LiNEc%t <br />8BP'rIo TANK PUI~ED: <br /> <br /> i 'f ~ QUANT i T Y AMOUNT <br /> SAND FILTER ,, 1 $3~5.00 <br /> <br /> 'TOTAL A,5~E~BD EEE, S $365.00 <br /> PREVi~ RECEiPT~ $365,00 <br /> THIS RECEIPT. $0.00 <br /> <br /> · DANCE ~E $0.00 <br /> <br /> RECEIVE0 BY- ~~l~J~ ~- ~" ........ ~, ~.~ ' ,TYPE: ~ECK ~: 0 <br /> SEE A'TT~EO ~U~T--FOR ~i~TS OF ~-SITE SEW~E <br /> <br />~ THiS IS A VALID P~iT ~ ~I~ ~IT ~I~ 360 ~ <br />~T~, FAI~ TO ~..A~ R~IR~ OF STATE ~ ~D <br />Z~INGO~ZN~C~. THI~ P~iT~B~~D~ID.. <br /> <br /> REMARKS: SAND FILTER <br /> <br />DO~ALB E.,~OOOLEY, MARION 6OJNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />