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MARION COUNTY BUILDING INSPECTION <br />SFNATQR BLDG. NO, 225 <br />¢~¢*0 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am e. fegi~,tered builder OR the authorized representative <br />of a registered builder, <br />The work will be performed by a registered builder, <br />Other, <br />I have read and agree to the ~erms stated on the reverse side of <br /> <br />I J)ETRO.,T DR 97Z4, DETROIT ~ I,O L [ <br /> <br /> PO [~OX 46I <br /> ~>E:'f'RO:['f', OR 77[~4t~ SITE NU~DER: 74-e~226 <br /> / <br /> PI-lONE: 854-'39~1 VALUATION: <br /> <br />TYPE: ON-STTE ¢JEUAGE HATER SUF'PLY: <br /> TEST HOLES RE~I)Y: <br />PERMIT OR APPLiCATiON NO: 985234~ SITE EVALUAT];ON NUMBER,,: <br /> EXIS'T'IN~ TANK S~[ZE: <br />CONTRACTOR, ,HO,, EXIST:lNG DRAIN FIELD LINES= <br /> P[jMF ED,, <br />[:~AL. BRAiTI-}. STEPHEN L ' c ............ _,. . <br />FO BOX 48}. ~ F-'REV~OUS NO,, ~E~ROOHS: ? <br />DET,xO.l.l~ Ok 97,~4,: <br />PHONE: 854-,39e:L <br /> <br /> ~ TE~ <br /> <br />AUI'HORIZATi[ON <br /> <br /> F'A,Y. EE~ [~ALBRAI T?i, <br /> ,d: I.~ ~ ~) BY,, <br /> ~17'2 ................ ::'-':: ......... ,"t~'" -".: <br /> ~l:,l:. A~IAfJ'IE~ DO.~UMENT F(; <br /> <br /> * THIS I9 NOT A <br />FOLLOWING MUS'r BE COMPL~ <br />ALL NECESSARY <br /> <br /> $0,, ~<4 <br /> <br /> :[NVO:[CE NO: 54793 <br /> TYF'IE~ IIq CH~ECK ~: <br /> <br />A REVIEW PROCESS WHERE THE <br />"?'HE APF:'L];CANT TO ASSURE t'HAT <br /> <br />Pt_Ah! REV ~:E:IdJ: <br /> <br />~EtY ........................... i)A'f'E ...................... <br /> <br /> <br />