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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 />of ~ registered builder. <br /> <br />OWNER'. <br /> <br /> AUHSV]:LL_E 01~ 97335 N~R'~ON COUNTY NO <br /> <br /> W~LDO ,[.,LLS FRUIT F;'hR~S <br /> 1575 C~,~;[D6E l)R SE <br /> <br />3,= AC. NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br />PERMIT OR AP~ICATION <br />I?:)N'f'~tAC'f'I:)R~ NO. 71161 <br />k(..m 5;(:hm,'..~ :,'~z <br />PO * OX 5241 <br /> <br />'::'~'~('.) N E ~ <br /> <br />WAT,ER SUF'I~LY: PW <br />TEST HI:!LES REAl)Y: YFS <br />SZTE EVALUA'I':[ON I,tUH;SER: <br />~X[ST;[N[; TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SF;P'fI6 Y'ANK PUMPED: <br />P¢~EViOUS NO. BEDROON~: <br /> <br />I II~H QUANT I'i'Y ANOLJ !q 'F <br /> <br />S.~:TF: r '~' , <br /> .WAL. UA,LOlI~ EA,, ADI)L_. LO]' <br /> <br />TCITAL ASSESSED F'EES <br />PREV:COUS ~ECr-']:F'TS <br />TH]'S RECE:[PT <br /> <br />~ALA>t,,E DbE <br /> <br /><; '1 '> 7 r <br /> <br /> RECE:rPT NO:: <br />TYPE: CF+E, CK 4~: 0 <br /> <br />:,.,,,: A]"TAQ-iED DOCUMENT --OR REQUIRCNENTS OF ON-SITE SEWA~:;E SYSTEft. <br /> <br /> ONS'I F;:UCT:[OC4 , I.l.~ ..~., HLff.;]` :BE: G~'~:~INE:~ BEFORE: BUi[]):[NG OR ,,:~cJ- ,;,C INSTALL. ATIO]4 [ ...... l i. ,, <br /> <br /> )',¢,) ) t.: O' ::'¥] q~:~""~ ]? .FY BiZ )]'G OFF'~[)¢~ / BY <br />FORM ¢ MC 16-66 R~, 4/* OF F IC E COPY V~b~ <br /> <br /> <br />