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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO, 225 <br /> 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> PHONIC; 588-5147 8:00 - 4:30 <br /> ,24 HOUR ~ODE~-PHONE: 5~-79~ <br /> <br />A[.JNSV~LLE OR 97325 ~AR~ON COUNT <br /> <br />SAHE ' <br />PHONE= 34~-'69~4 ~ ] VRLU~TION: <br /> <br />TYP£~ OH~SZTE SE~GE <br /> <br />PERMIT OR APPLICaTiON HO: <br /> <br />CONTRACTOR, NO. <br />PEAR~E, CHARLES <br />SAME <br /> <br />PHONE: ~63-6954 <br /> <br /> ITE~ <br />AUTHORIZATION NOTICE -.FL~.. Vi <br /> <br />PAYEE= PEAR~E. CHARLES, <br />~E~EIVED ~Y: CL .... <br /> <br />WATER SUPPLY <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />~XISTING TANK SIZE: <br /> XISTING ~RAIN F~EL~ L~NES: <br />SEPTIC TANK PUMPE~ <br />P~EVIOU$ NO; ~EDROOMS: 5 <br /> <br />QUANTITY AHOUNT <br /> <br /> TDT~L. ASSES~E~ FEES ~160.00 <br />'" '" · PRE~.[SUS .RECEIPTS $0.00 <br /> $168.80 <br /> <br />FOLLOWIN~ MUST BE ~OHPEETE~' 'I' ',~"TH~'"RE~PONSIBILI~Y,OF THE APPLICANT TO AS~LIRE THAT <br />ALL NECESSARY INFORMATION~,NAS'B~EN.,PRO~I~ED. ',." ".'.',,'..' <br /> <br /> ~--~ .... ,-T .... ~-' ' ............ , ............. <br /> <br />OFFICE COPY <br /> <br /> <br />