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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 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 58B-7904 <br /> <br /> I am a registered builder OR the authori:red representative SIGNATURE OF APPLICANT; ..... <br /> of a registered builder. <br /> <br /> PYTH i~ BUiLDiNG <br /> <br /> AU~RA OR 9?002 <br /> <br /> ~ONE~ { BiTE NU~ER~ 92~02231 <br /> <br />.................. 13 ~ 4S 1N 3 <br /> i ~ AC i NO NO <br /> <br /> TYPE: ~SJ'FE SE~GE NATER ~PPLY: <br /> ~1' HOLES READY= <br /> PE~z'r OR A~PLZCA'f'I~ NOt 40598 SITE EVALUATt~ NU~R~ <br /> EXis'rJN6 T~K S~ZE: <br /> <br /> PYTHJ~ BUJLDZNG SEPTZC T~K <br /> <br />COMMERCiAIt <br /> <br /> .f, TEM QUAN'f' .t TY AMD'UN T <br /> S'I'D ON$iTE ~,YS < 1000 GAL 1 $210.00 <br /> <br /> rOTAL ~ED ;'EES $210.00 <br /> PREVIOUS RE'CE i PTS $210.00 <br /> THIf5 RECEIPT $0,00 <br /> <br /> DANCE ~E $0.00 <br /> PAYEE ~ ~NVO~CE NO= <br /> RECEtVEO BYt ~ ................................................................ TYPE= ~ECK ~= 0 <br /> SEE ATTACHED ~N~T FOR RE~tR~ OF ~z'rE. SE~E SYST~. <br /> <br />~ TH~S ZS A VALID PE~T ~.: THiS ~T ~P~ 360 ~ <br />~ST~CTI~ EA~ TO ~f ALL R~ZR~T8 OF STATE ~ ~D <br />Z~JN60RD~N~C~, TH~S PE~.T ~ALL ~E NULL ~D <br /> <br />RPJ~1ARKS: REPA J,R <br />~ALD E. ~'~CY~DLEY, MARION C(~JNT¥ BUiI_O;[NG OFFIGIAL / ~¥ ................................... ~___ ....................................... <br /> V <br /> <br />~O.M # MC l S.5~.~v. 4~o OFFICE COPY <br /> <br /> <br />