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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 a registered builder OR ( ) the authorized repre~entatlve <br />o ~ rag s e ed builder. <br />The work will be performed by a registered builder, <br />Other ..... <br />I have read and agree te the terms stated on the reverse side of <br /> <br />· FITTING, JANES & MONiCA RESIDENTIAL <br /> <br />I AUMSVILLE OR 97325 MARION COUNTY ~NO <br /> <br /> CONTACT: 769-2~2 SITE ~HBER: 94 ~215 <br /> PHONE: ~ VALUATIOfl: <br /> <br />TYPE: OH-SITE SI[URGE WATER SUPPLY: PW <br /> TEST HOLES READY: <br />PERH~T OR&PPLICATION HO: '57~53 SITE EVALUATION NUMBER: 55442 <br /> EXISTING TANK SIZE: <br />CONTRACTOR~ NO. 45790 EXISTING DRAIN FIELD LINES: <br />VICTOR FRANK WILSON SEPTIC TANK PUMPED: <br />4ILS5 STAYTON SCIO DR <br />STAYTON~ 97383 <br />PHONE: <br /> <br /> PAYEE: <br /> RECEIVED BY-" <br /> <br /> SEE ATTACHED DOCUMENT <br /> <br /> $ THIS IS A VALID <br />CONSTRUCTION FAILS TO MEE~ <br />ZONING ORDINANCES~ THIS <br /> <br />1 $255,00 <br /> <br /> RECEIPT NO: <br />',:TYPE~ CHECK ~-" 0 <br /> <br />$255.00 <br /> $0.00 <br /> <br />$0.00 <br /> <br /> ITS ISSUE DATE. IF <br />MARION COUNTY GUILDING AH9 <br /> <br />REMARKS*. STKOUT TN FILE~: REViS~D,::;DATE~):: l&/::7794: <br />DOHALD E. ~OODLEY~ NARION COUN:TY'BUILDIN6 OFFICIAL / DY .................................. <br /> <br /> OFFICE COPY <br /> <br />FORM # MC 15-58 REV 4/~JO <br /> <br /> <br />