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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 8:00 - 4;30 <br />24 HOUR CODE-A-PHONIE~ $88-7904 <br /> <br />I Am a registered builder OR ~ ) the authorized representative <br /> <br />SIGNATURE OF A~LtOANT! .................................... <br /> DATE~ ............................ <br /> <br />rov~¢~: _DAT£,,__~2,Z.16z'93. .......... TIME...13;_44= <br />: BOOZE, KENNETH & JUDITH : 4~2~7-0~ ~ R~SIDENTIAL <br /> ........................................... ' ' ' <br />:'m~u~ ADD~S~? ' ""' "~f~EE~O~- ~ ........................... ,. <br /> <br />~ ....~.. .............................................. <br /> <br />TYPE: 8N-~ITE SEMAGE <br /> <br />PERNZT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />BOOZE~ KENNETH & JUDITH <br /> <br />PHONE: <br /> <br />48696 <br /> <br />WATEE SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION flUH~ER: <br />EXISTING TflNK SiZe:. <br />EXISTING DRAIN FIELB <br />SEPTIC TANK PUMPED= <br />PRE.VIOUS'NO';VBEDRODMS: <br /> <br /> ITEM · ,, QUANT I TY AMOUNT <br />AUTHORIZATION NOTICE FbD...VISIT ", ,. 1 $160.00 <br /> , ' : "' 'TOTA~ ~SSESSED FEE~ $16~. BO <br /> , :'...:.:F :: .""'...:./,:--. ,:~:,[:,TH~S'.'.REOEI~T:::'"~ ::' re. ~ <br /> ' ' :' '" ""' "".-"".:'~;':"':::~'~.~:':~0~ '".'.'J :: ~e, ~ <br />P~YEE= ........................... '" <br /> <br />REMARKS: AUTH <br />DONALD E. WOODLEY, MARION COUNTY BUILDING OFFICIAL BY <br /> <br />OFFICE COPY <br /> <br /> <br />