Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR SLDG, 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 />Iarn s registered builder OR (Ib4r[ne authorized representative SIGNATURE OF APPLICANT; ~ <br />of S registered builder. <br />The work wHI be performedott,er byaregisteredbullder. ¢/7/¢/ J ~ <br />I bare read and agree to the terms stated on the reverse side of DATE: <br />fhis document. <br /> <br />F T'TT );lql.;, jANI:ZL~ & HOP, ,'[. CA ~ RES Z D~NT ~ A L <br /> AUM,3VIL.LE OR 97~25 AR~ON COUNTY <br /> <br /> ...... I S~T~ NU~BEE~ ~4~ <br /> rMO' E, 74~-'].34~, ~ VALbAT,ON: <br /> <br />TYPE: ON-SITE SEWAQE WATER SUPPLY: PW <br /> TEST HOLES READY." <br />PER~IT OR APPLICATION NO-" : ?85795:3 SITE EVALUATION NUH~E~b.,. 55442 <br /> EX[STIN~ TANK SIZE: <br />CO?R~CTOR~ NO. 4577B <br /> ' S;'P · ' r :,.' . <br />41~55 STAYTON <br />ST~YTON~ ~73~F~ , <br />PHONE: <br /> <br /> 'f TE~f <br /> :: QUAI4'f'I TY <br />STANDARD ON--S]:'f'E SYSTEH: <br /> <br />PI.AN 4 ,,,V,1, LW,. <br /> <br />APiOUNT <br /> <br />SO., E)~ <br /> <br />:CITY JUR[8 CI-ION:DI l~Y ...................... DATE ........... <br /> <br />"~ORM # MC ~s-.~ R~,, 4¢~ OF F iCE COPY <br /> <br /> <br />