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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 />I am performing work on'-~-~,roperty I own or occupy. <br /> <br /> 11952 S']'EINKAMP <br /> <br />SAME <br />76~-5128 WK ~ SITE NUMBER: 94-8193~ <br />PHONE: 769-4272 ~ VALUAI'~ON: <br /> <br /> f <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CO[ITRAOTOR, <br />S;fMERAL, GORDON <br />SAME <br />7&?-'5128 WI( <br />PHOliE: 769-4272 <br /> <br /> WATER SUPPLY: PW <br /> TE~T HOLES READY: <br /> SITE EVALUATION NUMBER: <br /> EXISTING TANK ~IZE: 10~0 <br /> EXISTING DRAIN FIELD LIMES: <br />I DEPTIC TANK PUMPED: <br /> PREVIOUS NO. BEDROOMS: <br /> <br />ITEM QUANTITY AMOUI,FF <br /> <br />AUTNORIZAT.[ON NOTICE -"NO VI'B'IT <br /> <br />FEES <br /> <br />$0.0o <br /> <br />DUE $~.00 <br /> <br /> FAYEI~ .... , ~ , RECEIF7 NO. <br /> RECEIVED DY. DM ,~ ~ ......... TYPE. CHECK ~., 0 <br /> SEE AT1ACHED 90C[ MEI, T ~OR ~8~REME, i~,,T,,S,, OE ON~SI~E,BEWAGE SYSTEM. <br /> <br />ZONING ORDINANCES, 'tN;IS ,8EEM, I,~,",'~EbL ;~ECOME,NUEb AND,VOI~; <br /> <br />FORM # WC 15.56 n~, 4¢~ 0 F FICE COPY <br /> <br /> <br />