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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 S:O0- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />DATE: ............................................... <br /> <br /> GODFREY. ERNFST ; 75~B~78G i RESIDENTIAL <br /> , s~us'Ab'o~ss: ....................................... ,~5~s~Ab~fl'~.' ~9'¢~ ............................... ~b~ff4~b~ ...... <br /> ~ ~8;~4 SH¢~ S~ij~RE ~b SE ~'66~'~'~iY~ ...... ~'U~'~ ................. ,~'~6~; ' ' <br /> AUSHVIL, LE OR 97~25 ~ HA~iON COUNTYi NO ~ <br /> ,us~ O~ ~utlo~a: .................................... ~ '"J ........................... ~ .................... ~ ....... F~:-~'~S] ' <br /> ....... J 4 <br />~ ~1;1~¢ A~DR~¢S; ........................................... ' ................................................... ~ SUBDIVISIOn: ~ ....................................... <br /> <br /> ~ ~TE NUEBEE: <br /> PHONE: ~ VALUATION: <br /> ~¥87~ ................... ~bL'~i ................... ;eECTfOW'~ ........ .................................... <br /> ...... ;,_5~ ...... <br /> <br /> TYPE; OH-SZTE SE0~G/ WATER SUPPLY <br /> <br />CONT~ACTO~ NO,, <br />GODFbEY~ ERNEST <br />SA~E <br /> <br />PHONE~ <br /> <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1090 <br />EXISTING DRAIN FiEL9 LINES: <br />SEPTIC TANK POMPED: <br />PREVIOUS NO. BEDROOMS: 2 <br /> <br /> ITEM QUANTITY AHOUNT <br />AUTHORIZATION NOTIOE - FLD. VISIT 1 $160.¢~ <br /> TOTAL ASSESSE~ FEEs $160.~0 <br /> PREVIOUS RECEIPTS ¢160.0~ <br /> THIS .REOEIPT $0.80 <br /> BALANCE DUE $0.80 <br />PAYEE: ~ECEIPT NO: <br />RECEIVED BY; PB .......... - . : .................. . _.. . TYPE: CHECK ¢: 8 <br />SEE ATTAcNE~ ~OCUHENT FOR EEQJI~EHENT~'OF 8N-8ITE SEWAGE SYSTEM. <br /> <br />DONALD <br /> <br />AUTH <br /> <br /> WOODLEY~ MARION COUNTY BUiLDINr. OFFIC%AL / BY <br /> <br />Fo~ ~ ~c ~-~ ~ev, ~ OFFICE COPY <br /> <br /> <br />