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MARION COUNTY BUILDING INSPECTION <br /> <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: 5~8-7~4 <br /> <br />DATE: .......... <br /> <br />PHONE= 67B-5745 <br /> <br />-(~)'N'~T R UCTIO N TYPE: <br /> <br />OCCUPANCY: <br /> <br />O~:Cl IPANT LOAD: <br /> <br />SZTE, NUNBER: <br />VALUATION: <br /> <br />TYPE: ON-~TE SEWagE <br /> <br />PERHZT OR APPLICATION <br /> <br />CONTRACTOR. NO. <br />HAHN~ GLORIA <br /> <br />PHONE= 678-5745 <br /> <br />WATER SUPPLY= PW <br />TEST HOLES READY= <br />SITE EVALUATXON HUNDEE: <br />EXISTING TANK ~IZE: <br />EXISTING DRAIN FIELD LINE~= <br /> <br />PREVI~S NO. [[DROOMS: 1 <br /> <br />AMOUNT <br /> <br />$220.60 <br />$16e. oo <br /> <br /> K~CEIVEO ~Y. CL : , ' . ' ... .,' ..' .-. ~. '-.-.;'.~.-'.'.....' .-:... · TYPE: CHECK ~- <br /> <br />P~gL~G MUST BE COHPLET&~?~7~I.:}~8,R~I[,I~.y,.:OF;~THE APPLICAMT TO ASSURE THAT <br /> <br /> PLAN ~EVIEW: BY DATE .... .~_=~ .. ~Y JURISDICTION: 8Y DATE <br /> ...... ~ '-'- ... . .... , ,,.,~ :: .~.:: <br /> REHARKS: $S/flUTH - DRA~NF'IEL~' REPAI~ '". ,,,,;' .... '..~ ...... · <br /> <br />FO~ # MC ls.r~ ~v. ~ OFFICE COiry <br /> <br /> <br />