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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-PHONE: 588-7904 <br /> <br />~IGNAYURE OF ^P?LIOANT: ................................................. <br /> OATE <br /> <br /> { <br /> !"~,~ i~'~'R¥, W:[£L':[A~ ....................................... ~ ~o~'~ ............................. ['~T~'4C ....... <br /> <br /> ~'~ ~¢-u'o~I'~'~SV~'~E ....................... ~,.,,,.,-,~7~ ............. ~A~-OSUNT-~ ~ ............................ 1 ~,~,~. <br /> ~7~'~-AD~A~'~ ................................................................................................................... J ..................... <br /> <br /> . ~ SITE NUMBER: 9~-~2674 <br /> '. <br /> <br />................ ~ .......................... ~ ....... ~~ ........................ J ................. <br /> <br />TYPE: O~r~ITE SE~E <br /> <br />PERHIT OR APPLICATION NO: 9~48~6 <br /> <br />CONTRACTOR. NO. <br />TOWERY~WILLIAM ....." '""II'"' ....... '' <br /> <br />PHONE: : <br /> <br /> WATER SUPPLY . <br /> TEST F~LES REAbY. <br />SITE EVALUATION NURSER: <br />EXISTING TANK SIZE. <br />EXISTING,~N ~IELD L~NES: <br />SEPTIC TANK PU~P~B: <br />P~EVIOU~ NO. BEDROOMS: <br /> <br /> "'' ' , · "' QUAN1'~Ty A~OU~T <br /> '-'~' ''' ' '; '" '· ' ..... ..' $0,~0 <br /> <br /> ' ....... C,,,,,.~.. , .... .... ,,.". · ~- <br /> ,: ,,,.,...:".',::,,~.~.. ....... -..~t~cg:~:~oEc..:!~..~,,', ..: <br /> RECEIVED BY: <br /> <br /> ' .; .... · .... ~uM~z~E'm'~,QF THE APPLICANT TO A~SURE THAT <br />ALL H~CESSARy INFORNATION' <br /> <br /> ..' · .. , ..... ,, ,, <br />PLAN REVIEW:BY DAT~ CITY JURISDICTION: BY DATE <br />REMARKS: TRANSFER P~47726 TO TH~S SITUS <br /> <br /> <br />