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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 a regiCtered builder. <br /> <br /> Other. <br /> <br /> ", 4~)242;J07. ~ F;....DEb .~- ._ <br /> ~. f;.D'..~[1N,~ ..~(;~"~N c,', ,='",.' <br /> <br /> : NO OF 8EOR~OMS: <br /> <br />MAILING ADDRESS; SUBDIViSiON: <br /> <br /> 4361 I,L!:¥RS;~JI)E i,,f[: ................................ <br /> NC:!i:~:i,tb:V;:~l E,, OR 9'~ S~TE NUMBER= <br /> PHONE: 472-26::~5~ VALUATION: <br /> <br /> ~ ~ ' :LW E~.. U , 4 <br />WIDTH: I~H: ~ AREA; ~ UNITS: ~RREG, LOT: CORNER: <br /> , ; 34. AC ' bio <br /> <br />PERMIT OR APPLICATION NO: <br />"'.(!l,!' 'R ~t ::" ] I-.'.' ~. <br /> <br />4361 R.[W~S.I]?E DR <br />MCM:[ {qN V'D._I..E ~ OR <br />F ,,.Ii ; 47. .6-'- <br /> <br />BATI_,'R SUPPLY: <br />',"EST HOLE!~. READY: YES <br />S.'( T E EVALUA'f'IOi,; <br />EXISTING TANK <br />EX:FS'I'):NG DF'AZ{,] FIEL. D LINES'.i <br />SEPI"rC TANK F'UHPED: <br />PI~;E.¥JJ;OUS NO,, BEDROOMS: <br /> <br />S:{?E FYALLAT.~.O., EA,, A~'¢I;,: ,, LO'r' <br /> <br />QUANTITY AHOLh, Ff <br /> ','. $ 225. <br /> <br />~ ,if....I.., )',Ai'.[D.)Otl,) ,JOHN <br />FU':.(';F-":V[:.!) I:Y: (:3 ................................................................... <br /> <br /> RE_-CE I P7 NO~; 5696~ <br />TYF'E': ~ix CH~:LP, :~: 3998 <br /> <br />.,L,. f~! A¢.i'~".t DOCI. I!~Et'IT FOR RE(,~U;[REME!,ITS OF' ON-.S:t.T[( SEWAGE SYSTEH, <br /> <br />FORM # MC ~5,56 REV. 4/90 OFFICE COPY <br /> <br /> <br />