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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, ORI~GON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PER~.tT OR APPLICATION <br /> <br />CONTRACTOR,~ N0. <br />WAI'TS~ BFC(AN H <br />SAME <br /> <br />PHON[:.[ 749~.:~ 49S <br /> <br />WATER StJPPLY: F'W <br />TEST HOLES READY: <br />SITE EVALUATIOIq <br />EXISTZN[; TANK 8ZZE: <br />EXIST~NE DRA,I'N FIELD <br />SEPTIC TANK PUNPED~ <br />PREVIOUS NO~ <br /> <br /> £I'EH ............................................................................................... <br /> L]UAhlT/TY AMOUNT <br /> <br /> TOTAl. ASSES~ED ,F'~E8 <br /> PREVZOUS R~CE:[F1'o , q, <br /> TH.~g RECEIPT tltJ, 6~,, 0~ <br /> ~.,ALA~[,[. DUE Sf],, ~k' <br /> <br />RFCE)~V[~D BY: ~b RECEIPT NO: <br />........................... · _~:=-';.:..:-_.=.=-===-~==.:,.::=-~==.~..~:;,;===,.~=.=..~===== ........ TYPE: CI( CI"~E'CK ~:: 348:L <br />St:]~' AqT~CI4ED DOCUHENT FOR RBDU[REHENTS OF 8N-SZTESE~GE ......... SYST~H,:'~': .......................................................... <br /> THIS IS NOT A PER~I~. THI9 A ~L ~ATIO O TH O H REVUE P C[SS <br /> Ni:LJ::,. SAxY II~FORMAI]'.[IN FIGS, BEEN <br /> <br />F'LAH RF'Vth'k;~ BY ..... DA~[ ................. ~_ CITY JOR];SI)IC'f']:ON: BY ......... ~ ............. ~)ATI~: ............ <br /> <br />FOR~I ~ MC 15-5~ BEV, 4/~0 OFFICE COPY <br /> <br /> <br />