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MARION COUNTY BUILDING iNSPECTION
<br />SENATOR ~LDG, NO. 225
<br />220 HIGH STiClE~T NE
<br /> SALEM, OREGON 97301
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<br /> PHONE: 5~-$147 ' 8:00 - 4:30
<br /> 24 HOUR CODE-A-PHONE: '588-7904
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<br />' ROSE' ................................... FRANKL IN RESIOENTIAL
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<br /> ~UM~V[LLE OR 97325
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<br /> 52[0 RIVER ROAD H ~lO00 ~ ........................................................................
<br /> KE[ZER ~7303 OFFICE 59~-362~ X-~50
<br /> PHONE: 590-9~5~ t VALUATION:
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<br />TYPE: ON-SITE ~EWA6E
<br />PERHZT OR APPLICATION NO: 42400
<br />CONTRACTOR, NO.
<br />ROSE, FRANKLIN
<br />5210 RIVER ROAD N ~iO00 .
<br />KEIZER 9750~ OFFICE ]9~$'2'~"X-
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<br />WATER SUPPLY= PW
<br />TEST HOLES READY:
<br />8ITE EVALUATION NUHB~R: 28245
<br />EXISTIN8 TANK SIZE:
<br />EXISTING ORAIN FIELD
<br />SEPTIC TANZ PUMPED:
<br />PREVIOUS NO.,~EOROOM~:
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<br /> PHONE: ~90~7555
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<br /> ITEM " ...... · '" .... '"' ' QUANTITY AMOUNT
<br /> STANDARD ON-~ITE '"' ........
<br /> SYSTEM .... ;, ,, .,~' .' ' ,' ], $210, O0
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<br /> : .... . "' ~,,,., :.' '~..'. '...'., r ,,, TOTalLY. A~"ESJ~D".'F(E$ $2Z0. O0
<br /> ;' ' ',' ', ,,,,".' r. %',... ; ', ,%,.RR~V~OU~EO~[pTs $210. O0
<br /> ' ... '.;;'". ;.: ~::'. '. '~'." .",; '"',' ",'" .~H'~8"~'~CE~PT '~ .".' ', $0. O0
<br /> ".: ,,,,..' ,.L .... ' ,
<br /> P~YEE ~ .................. ·.... ,: ..: .', ', ', ,,'. ..... . RECEIPT
<br /> IV Y* - ,'" ":';' '" "';,', ' .
<br /> RECE ED8 . C r ..... ' ..... ~ ............ ~ .............. TYPE. CHECK ~. 0
<br /> SEE ATTACHE0 OOCUHENT :'FO~?~EQ~REHENT,S,"~F:.'ONj~ST~'E",:SE~E '.SYSTEH.
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<br />CONSTRUCT~ON F~LS TO HEEI:'~j~C,;,RE~U~tS':~O~,-'~'T'~.yE~"~,NS '~NO HnRION COUNTY BUILDING
<br />ZONIN~ O~OZNnNOES, THZS] PEE'H~T.:~JSRBLJ,BEOOHE.:,ND~L,'.ANO.:w~.~,.
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<br /> REMARK~t~
<br /> DONALD E, WOOOLEY, HARION:"COUN~Y ~UIbD~NG.O'FF~O~AL / BY ...... ~_
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<br />OFFICE COPY
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