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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: 5~-514.7' 8;00- 4;30
<br />24 HOUR CODE-A-PHONE: 588-7904
<br />
<br /> WEI'fHAN~ RICK S. ! 6~487-00~ .;, RES~gEN'r~AL
<br />
<br /> AUHSVILt. E ' '
<br />................................................ ;..... · .. L__=..' ... ............
<br />~0~ b~ su ~o~5. · j NO O~ ~EOrOO~s:
<br />
<br /> SAME ~ ........................................................
<br /> PHONE:: 76~-5837 ~ VALUATION:
<br />
<br /> TYPE~ ON-S~TE SE~ACE WA~R ~OPPLY
<br /> ~RHZT OR A~LICATI~ ~ 4S~9' 8ZTE ~ALUAI'IOW .HUMBER:
<br /> EXISTING TANK ~IZE:
<br /> 0ONTRACTO~.
<br /> i EXISTINg DRAIN F~EL]) LINES:
<br /> ~EPT~C TANK PUMPE~:
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<br /> PHQN/~ 769-5837 . l
<br />
<br /> ~T[M QLIANTZTY
<br /> ANNUAL EVAL.
<br /> ' ' ,"':~. ~.": ',,,' ~//,~:~ ';./'.,,',,x'..,' ,?: '":,,,' .' ','
<br />
<br /> ....
<br /> PAYEE: " ,, ":'".-' ,r?.....:, ,, ~'""'"<"::~.':>-~.'.":~,,v'~';.~:':'.:,;,~,~',''
<br />
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<br /> RE;MARl(E;:
<br />
<br />~JhlALD E.
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<br />OFFICE COPY
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