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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
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br />SITUS ADDRESS; I ~O~i~I'R0~TiON ~Y~; i OCCUPANCY:
<br /> .............DONTRADT CITY: ; UGh;
<br />
<br /> , '4' 'r -' PT..,~,..,,~ MARL~0N COUNTY
<br /> , ] .,, ~,,I,,,lJ. 0R *'"~'~ ,
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<br /> ":"" ......... r' ~ WALDO HILLS FRUIT EARMS
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<br /> ~,, AC iq~ NO
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<br />TYPE: oN-$['rE SEWAGE
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<br />PERi4IT OB APPLICATION
<br />
<br />COhrTF!AC1FOR,, 1,; . 71
<br />
<br />PO B(.IX ~24I
<br />
<br />54492
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<br />WATER 8UF'PLY: PW
<br />TEST HOLES READY: YES
<br />SITE EVALUATION bJUHBER:
<br />EXISI Il,lC, TANK SIZE:
<br />~]X.~STING DRAIN FIEiLD LINES.,
<br />SEPTI~ YANK PdMPED:
<br />PREVIOUS NO., B~DROOMS:
<br />
<br />TOTAL e,-ee'-
<br /> A,,~SEooED F"EES
<br />,PREV].OIUS RECEIPTS
<br />T H ,.] ,'.3, RIEC~.-_ I PT
<br />
<br />· ,,,. ....
<br />$225,,
<br />
<br />BALAHCE DUE
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<br />RECEIPT NO:
<br />
<br />R;zr;I:'rvFL~ P~y: PB 'TYPE': I,,HE. CK %: 0
<br />,.~,-_h. a~' IA,Hi..]/ OOCUHEN[' FOR RF[QtlIR?~MEi,~/~ OF Ot,I-~tTE SEWAGE SYS-f'EH~
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<br /> ~,, ,~ ..... ~., ~,'J/J. AI,h;:,f~ (JF' }k.~; [ PI t S. ffI~['/.'i' iqli!iiZ~) P[,J~{:',. ~,~
<br /> ,/ ............. I.AO ..... , :' ~:'.'.i? .... ..:UT, ~iUi_DIM:; }F'F':O'.,,IJG .... I')Y ..................... ~
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<br />FORM # MC 1 S-56 RE',/, 4/90 OFFICE COPY
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