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MARION COUNTY BUILDING INSPECTION <br />SENATQR BLDG, ND. 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 />of a registered builder. <br /> <br />Other ........ <br /> <br /> DATE: ~1/21/94 TIME: <br /> <br /> SAME <br /> SITE HUHBER: 74-1~1~295 <br /> PHONE.. 749-1604 i VALUATION: <br /> <br />, ~ ~ , ~ · ~ , ~ · ~ , <br /> ~ ~ SS 2W ~ EFU ~ St <br /> <br /> T~J ~-SITE SEWAGE WATER SUPPLYJ PW <br /> <br />PERHIT OR APPLICATION <br /> <br />CONTRACTOR, NO. <br />ELLIS~ CARLO <br />SAME <br /> <br />PNQNE: 747-1604 <br /> <br />9a§2419 <br /> <br />TEST HOLES READY: FRIDAY <br />SITE EVALUATION HUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS,NO. BEDROOMS: 2 <br /> <br />ITEM QUANTITY AMOUNT <br />REPAIR - MAJOR 1 $125.00 <br /> <br /> PAYEE: INVESTORS MORTGAGE.'t <br /> RECEIVED BY: CL <br /> <br /> SEE ATTACHED DOCUMENT <br /> <br />FOLLOWING MUST BE <br />ALL NECESSARY INFORMATION: <br /> <br />$125.08 <br /> $0,08 <br />$125.00 <br /> <br /> RECEIPT NO: 54938 <br />TYPE: CK CHECK J.. 2564 <br /> <br /> REVlE# PROCESS ~JHER£ THE <br /> THE <br />OF; APPLICANT TO ASSURE THAT <br /> <br />PLAN REVIEW: BY --.-::,: ( ,J~g!~D!CTION: BY DATE <br />REMARKS: EXISTING TAN~ AND DRAINFIELD F'AI,LING -,~fAJOR .REPAIR <br /> <br />FORM # MD 15-~ REV, 4/~0 OF FIDE COPY <br /> <br /> <br />