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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 9'7301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered builder OR the authorized representative <br />of a registered builder, - <br /> <br />DAI'E: <br />~DR~SSi CONSTRUCTION TYPE; , OCCUPANCY'. <br /> WATTS,~ BRIAN H 5&~2,.,,~4 ~RESIDENT~AL <br /> CONTRACT CITY: b~ ~ OCCUPANT LOAD'. <br /> <br /> SAME " <br /> <br />2. AC NO <br /> <br />TYPE: DH-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONI'F(ACT,O.R,, I,!l,). <br />WfiTTS~ BRZflN H <br />SAMK <br /> <br />F'HOHE; 74~-14~5 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES RFADY: <br />S:!,TE EVALUATION WUHBER: <br />EX.ISTING TANK SIZE: 1~00 <br />EXISTING DRAIN FIEL. D L?ES: <br />SEPTIC TANK PU~PE~: <br />PREVIOUS NO. 8EQROO~S: <br /> <br /> ITEM £~UANT I T¥ AMOUNT <br />AUTHORIZATION NOTICE - FI.D= VISIT <br /> <br /> "FOTAi,. ASSESSED FEES $:L6P~,, <br /> PREVIOUS RECEIPTS <br /> THIS ~CEIPT <br /> <br /> ~ALANI]E DUE $180. <br /> <br /> F AYEE,. RECEII"T NO: <br /> ,,,.,c,., ,,'_'.,, ;~Y. l'fl.~ TYPE: CHECK ~:: <br /> ~EF', ~-rf'hgl.lfCp DOCUNENT FOR RESUZRL::NENTS OF ON,~SZTE ,~E~l:r'., - SY~¢EH.,' e-" <br /> <br /> ~ THIS IS ~OT A PER~iT THiS A:P~LICATg8 8 6 0 ~H R .P ~ 8 <br /> <br />A,_. ,~(,'ZS~A~Y I~FORDATION HAS BEEN' PROVIDED. <br /> <br /> ~'~ DH ~,¥:VIFW: BY_ DATE L CITY JURISD,I, CTI01I. BY..,,,,: .............. DATE ............. <br /> <br />~o~M ~ ~c ~-~s REV. ',~o OFFICE COPY <br /> <br /> <br />