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MARION COUNTY I~UILDING INSPECTION
<br />,~ENATOR ~LDG. NO, 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br />mILE
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<br /> PHONE: 588-S147 8:00 - 4:30
<br /> 24 HOUR CODE-A-PHONE: 588-7904 ,
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<br /> KR~
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<br /> PHONE:
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<br />TYPE: OH-SITE
<br />PER~IT OR APPLICATIOH
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<br />CONTRACTOR. NO.
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<br />LARRY KRIB$ 67B-2141.."
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<br />WATER SUPPLY: PW
<br />TEST HOLES READYt NO
<br />S~TE EVALUATION NUMBER:
<br />EXISTIN~ TANK SIZE=
<br />EXZ~TIN~ DRAIN FIELD L[NES:
<br />',SEPTI'C,TANE,,PUMPED=
<br />PREVIOUS ND. '~EDRDDMB:
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<br /> ITEM ", : '. · · ",'.., "'::'' QUANTITY AMOUNT
<br /> REPAIR - ~AJOR -'. . · ,,,, ,,. I $125.0B
<br /> "..":' ,'' ..... '...:-TOTA~,,'A~E~SED ~EE$ $125.8~
<br /> · '" .'" :.'":', "', :',:':', ' '" "'.,..': ~RE'~;~'I~OS'?RE~E~PT8 $0.00
<br /> ' .. ":" ';"".7':", ".::': ~.'.'~H~:'.~EF-~:~'~T~ '" ". $125.00
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<br /> RECEIVED BY= DM2 '..:''.:'.:" ,;)~"~'..:;'~,',,,'.,,:i',.:, .: 'TYPE: n~ CHEnK ~- ~0628
<br /> SEE ATTACHED DOCUHENT' FBR"~EO~'I~H!S OF'~N~S~,T~,,',S'EWA~EjSY$TEM.
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<br />OLLOWING MUST BE COMPLET,E~;, IT:'.',;IS,."THE/ RESP, O~tBIL:IT~ :O~" TH~ APPLICANT TO ~$$URE THAT
<br />ALL NEC~8~A~Y INFO~MATIQN~.HA$,'B~E~L~RO~IQ~D¢' ," .:~'..."4: ,/
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<br />REMARKS. MAd REPAIR
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<br />READY NO
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<br />OFFICE COPY
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