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MARION COUNTY I~UILDING 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: 588-7B04 <br /> <br />of a reg s ere,B builCer <br />The work win be me,formed by a reglsterecl builder, <br /> <br />,~IGNATURE Of APP~,I~ANT ....................... <br /> <br /> OATE; <br /> <br />WEITHAN,~ R:[CK $. &R,467-080 i RE'.S ~DFJ:NT TAL <br /> <br /> 1 ~ <br /> <br /> AUMgVZLL, E OR ~7325. jr, AR~ON COUNTY ~ NO j <br /> <br /> oAME <br /> <br /> P'HONE~ 7~?-5837 <br /> <br />WIOT~: JOEPTH; J AREA: <br />........................ E.._L ....... LI ..... <br /> <br />P~R~!T OR APPL~CAT~OH <br /> <br />I~ONTRACTOR. NO. <br />WE:[TMAN, RI:CE S,, <br />SAME <br /> <br />PHONE: Y69-5837 <br /> <br /> ITEM <br />ANNUAL EVAL. - TEMP <br /> <br /> WATER SUPPLY: F'W <br /> TEST HOLES REAl)Y: <br /> 61~49 SITE EVALUATION NUMBER: <br /> EXISTING TANK SIZE: <br /> EXISTING DRATN F'~E'LD <br /> <br />,'"';' I F~ViOU~ NO. BEDROOMS. <br /> <br /> . ,,, gUANTZTY <br /> ~,,';,~,..~: <br /> <br />ANOONT <br /> <br />SJ,: ,, 0~,, <br /> <br />OFFIOE COPY <br /> <br /> <br />