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FOR OF,F~CE USE ONLY <br /> <br /> MARION COUNTY BUILDING INSPECTION <br /> 220 High Street NE <br /> Salem, On 97301 <br /> <br /> 8:00 a,rn,-4;$0 p.m, Phone 588-5147 <br /> Code-A-Phone 588-7904 <br /> FAX 588-7948 <br /> <br /> SITE EVALUATION APPLICATION <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br />1. Location of Installation <br /> <br /> ol-qO0' <br />Mobile Ilome Park S~cc~ .... <br />' i~x 'Wkkh ....... <br /> <br />2. Installation <br /> <br />3. Septic Information (Check where applicable) <br /> <br /> W;tler Supply: Well [~ City [] Spring [] <br /> <br />Res [] S' gte Fan 'ly Dwelling [] Accessory Structure [] Other <br /> <br />Evaluation Fcc: <br /> <br />Receipt No. <br /> <br />Total Amount; Due: <br /> <br />Test Holes Ready: <br /> <br />Will Call When Test Holes Ready: <br /> <br />Signature of Owner or Authorized Agen~~ <br /> <br />This is a technical report for on-site sewage disposal only and does not grant or <br />imply permission to build on this parcel. Planning approval, construction and septic <br />permits must first be obtained before building or septic installation begins. <br /> <br /> <br />