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MARION COUNTY BUILDING INSPECTION <br /> <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> <br />of a registered builder, <br />The work will be pedormed by a registered builder, <br />Other ...... <br />I Mare read ~nd ~gree to the terms stated on tl~e reverse side of DATE; ..... <br />this document. <br /> <br />TAX LOT: ' <br />CONSTI"!UD"¢IO N TYPE: OCCUPANCY: <br /> <br /> I;H[ I,fE~ 508'"5724 ~ VALUATION:: <br />W DTH DEPTN'. ; AREA; UNITS; ~ IRREG, LOT: ~ OORNER: <br /> <br />PERNIT OR APPLICATION <br />CONTRACTOR NO. 7.1.'L61 <br /> <br />PO I~OX 524;I, <br />Sale % <br />F'}I{']N~:: 388-1. [15 <br /> <br />9~54487 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: YES <br />SITE EVALUAT,~:ON NUNBEf.~: <br />EX:[STIN~ TANK S]:ZE'-' <br />EXISTINg; I)RAZN t',:'IEI,,,D LtNSB: <br />SEF"[IC TANK PUNPED: <br />PREVIOUS NO. ~EDROOHS: <br /> <br /> II'Fi,'i QUANT:i: TY A M, hi <br />~ - - $ ~_ 6 ~,. ,;1 .~ <br />· ~ I ~,, ~:V~L,I.J~TION~ F:[R,.~ LOT ',l, "~ ~' "~' <br /> <br /> TOTAL A~S~SSEI) I'.,.I',;S $~.5 ,, ~ <br /> <br /> TH~S RECEZPT ~ ,: ..... (:~, <br /> ~ALAHCE DUE ~$~, ,;~ <br /> <br />PAYEI'..': LARRY t(E'[.J~EI._~.. RE~E~[PT ~01; 56952 <br />.............. I '"",.' ~: <br /> d,L,I.V;O ~Y~ PH ......................................................... TYPE~ Clx L.-IZC,x ,L827 <br /> <br />,.,~;:" .... Al i ACHIr, D I)O[,UH:,NT FOR REQOIRE~ENTS OF ,~N-sI'rE S~WAG~ SYSTEH,, <br /> <br />OFFICE COPY <br /> <br /> <br />