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MARION coONTY BUILDING INSPECTION <br /> <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br />SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 L'4:30 <br />24 HOUR CODE-A-PHONE: 588.7904 <br /> <br />I ~m pe[torming work on a property 1 Own or occupy. , · <br />I am e r .e~[tstettd ~uildcr OR ( ) the authori[ed representative SIGNATURE. OF APPLICANT; <br />of e mg!~te~m~ builder. . <br />The work wllJ be performed by a F~>glstered builder,, <br />Other-.. · ' - ...... <br /> <br /> AUH~VILLE ~ ~. 97325 ~,.~.,~AR~ON~ COUNTY{~__..___ _NO' ~ ........ ii <br /> <br />TY~E~ O~S[TE SEWAGE ] W~TE~ ~UPPLY: PO. <br /> J TE~T HOLE~ RE~DY. YES <br /> <br />CONTEACTOR~ NO. 8581~ J EXISTING DRAIN FIELD LINES: <br />A ~ B Septic ~ervice Inc ~.~ I SEPTIC TANK <br />7~25 windsor Is Rd N <br /> <br />PHONE: 393-131t ;.[~' ~ <br /> <br /> ~TEM <br />REPAIR -- MAJOR <br /> <br /> PAYEE: A &'B Septic ~r' <br /> RECEIVED BY~ P~2 ~, <br /> <br /> SEE ATTACHED DOCUMENT~F <br /> · THIS ~S N~T A <br />FOLLOWING MUST 8E <br />AL.L NECESSARY IHFORHAT <br /> <br />........ "' QUANTITY AMOUNT <br />'"' ":.:' ::, i ~125,,00 <br /> <br /> $0.00 <br /> <br />RECEIPT NO: ~0574 <br />TYPE: CK CHECK *: <br /> <br />ro,~ # uc ~r~.~ R~v,~ OFFICE COPY <br /> <br /> <br />