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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 588-5147 <br /> CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br /> of a registered bulmer- <br /> The work wHI be performed by a registered builder. <br /> Of her <br /> <br />gATE: 08/21/87 <br /> <br /> DALKE, DAVIB <br /> <br />RESIDENTIAL <br /> <br /> 9824 WEST STAYTON RD SE .... l~JGO: '>OGOUPAN+~.SAD: <br /> AUMSVI LLE OR 97325 ~ I <br /> <br />S~EA ~ <br />PH~E: ~ SITE NUMBER: 2289 <br /> ; VALUAT l ~: <br />LOT' 8~0K: ~18~: ~'~ '~ ~U~ <br /> I I [ 9S ~ 2N ~ EFU <br /> ~ 2. 00000 AC NO [ NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERN]:T OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 53478 <br />SUNRISE INVESTMENTS <br />PO BOX 56 <br />TURNER, ORE(~::A~ 9?392 <br />r::~flONE; 743-2131 <br /> <br />9003933 <br /> <br />WATER SUPPLY; PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />ES(ISTING TANK SIZE: <br />EXISTtNS DRAIN FIELD LINES: <br />SEPTIC T~NK PUMPED~ <br />PREVIOUS NO+ BEDROOMS: <br /> <br /> ITEM QUANT I TY AMOUNT <br />ALTERATION 1 $100,00 <br /> <br /> TOT, AL A,~3SEEx.SED :FEES <br /> r:: ~'REVIOUS RECE ~PTS <br /> <br /> NO: <br />CHECK <br /> <br />$100.00 <br /> $o.oo <br />$?o0.oo <br /> <br />$100.00 <br /> <br />PAYEE: ':"~ .... <br />RECEIVED BY: JB :~: . TYPE:' <br />SEE ATTACHED DOCUMENT FOR ~EQUiRfiN~JqT~; <br /> <br />* ~IS IS ~T A PE~IT. ~IS ~I~TIC <br />FOLL~iNG ~T BE ~PL~ED. <br />ALL NEC~ IN~TI~ H~BE~ <br /> <br />~LAN REVZE~; BY <br /> <br />R~A~KS; ALTE~AT[~ <br /> <br />FORM ,~ MC 15-58 REV 6/87 OFFICE COPY <br /> <br /> <br />