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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: 588-7904 <br /> <br />PILE <br /> <br />I am a registered builder OR ( ) the authorized representative <br />of a registered buitder, <br /> <br />Other <br /> <br />m DETROIT OR 97~42 DETROIT ~NO J <br /> <br /> GOL~ BEACS OR 9?444 SITE ~U~BE~: ~4-8812~ <br /> PHONE: 247.-75&6 VALUAT]:ON: i <br /> <br />TYPE: OH-SITE SEWAGE WA'fi!:_'!:;: SUF'F'LY: CW <br /> TEST HOLES READY: <br />PERMIT OR APPLI~ATIDH ND: 90~2217 SITE EVALUATION i,IUMBER: 429 <br /> EXISTING TANK SIZE: <br />CONTRAC-fOR~ NO. , ~ EXIS'!'IN6 DRALrN FIELD LINES~ <br />WHITE:~ ~RAf, ICZS & PAFFRI~.iA SEPTIC: TS~K PUHPED: <br />;e4]& DRIFTWCOD DR' :'' P~:VtO~ NO. BEI)RO0~S: <br />GOLD BEACH OR ~'244~4 ' <br />PHOI,IE: 247--'7~55 <br />............................................. L_,,;L ...... ......................... ........................................................................................... <br /> ' :' '::] ] : (ttJANTITY AMOUNI <br />STANDARD ON-SITE SY~TE~ c <br /> <br /> ~ '": TS $0,, 8~ <br /> <br /> PAYEE: WH!"FE,~ <br /> REE;EIYED BY: Pf~ <br /> <br /> SEE ATTACHED DOCUMENT <br /> * THIS IS NOT A Pr~'R~I'J <br />FOLLOWING MUST BE C0~{PLI~ <br />ALL I,II..T. CE.:SSARY ]:HF'ORMAT:(E <br /> <br />'_1: N V 0 :F CL;: NO: 54678 <br /> <br />REVIEW PROCESS WHERE THE <br /> <br />PLAN <br /> <br />REMARKS: <br /> <br />soa~a ~ MC lS.~ aav. ~/~ OFFICE COPY <br /> <br /> <br />