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~ FOR CITY USE ONLY <br />R~ceived By: __ <br />Zgning V~alidation: <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St, NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am-4:3Opm Phone $8~-5147 <br /> 24 hr. Inspection Line 373-4427 <br /> FAX 588~7948 <br /> <br /> SITE EVALUATION AND/OR SEPTIC PERMIT APPLICATION <br />1. LOCATION OF INSTALLATION ~/-- Iff.~~--~ <br /> <br />2. CONTRACTOR INFORMATION <br /> <br />[ <br /> <br />3. FEES <br /> <br />MC 15-SI Rev 8/96 Pumping Certification Attached: (Y) (N) <br /> <br /> <br />