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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 H~GH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:$0 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> The work will bo Derformed by a registered builder. <br /> Other <br /> <br /> DA'f~'.: i~/2:1,/9,~ TIME;: 11,,~7.17 <br />'ow' ~R~ ................... . ' ~ LOY', ................... <br /> <br /> AORORA OR 97~2 ~RI~q ~OUNTY~ <br /> ~s~oP ~omLomNQ: <br /> <br /> WALLER BOYES .......................................... <br /> 547 SE 74TH PORTLAND 97215 SITE NUHBER~ <br /> PHONE: 251~-2847 VALUATION: <br />~'C~ ...... ~bOE~--""~ - [~scz~'~= ................. ~ ~5~ .......... ~w~ ............. <br /> <br />i ............. ~ ............ l ............. ~ ~ ~ .................~ ......... <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNIT OR APPLICATIOH <br /> <br />CONTRACTOR, <br />~AV];DSObI~ JOHN <br />WALTER BOYE8 <br />547 SE 74TH PORTI..AND' 97215 <br />PHONE: <br /> <br />WATER ~UPF'LY: PW <br />TEST HOLES READY: 9-20-9~ <br />SITE EVALUATION NIJHBER: <br />EXISTING TANK SIZE: <br />EXISTIN~ DRAIN FIEL9 <br />SEPTIC TANK PUMPED: <br /> <br /> ITEM <br />~ITE EVALUATION~ FIRST LOT <br /> <br />PREV. IOU:SRECEIPT~ <br />'TNI$'R~CEIPT <br /> <br />· ~ALANC~ DUE' <br /> <br />QUANTITY AHOUNT <br /> 1 <br /> <br />$0.00 <br /> <br />$0.00 <br /> <br />FAYEE,. RECEIPT NO: <br />EECEIVLD BY:: PB TYPE: CHECK <br /> <br />~BE ATTA~HE~ DOCUMENT FOR REQUIRE~gNTS OF ON'SITE SEWAGE ~YSI'EH. <br /> <br />NOTE: THIS DOF.~ N~T GRAhT OR IMpI;Y; PERMiI~SIO~I TO B~ILD OH TH[~ PARCEL P.A, qING ANO <br />ONSTRUCTION PERMITS MUS~ 9E O~ZA!~E~'B'EFORE BU~LQ!NG OR S~PTIC INSTALLATION BEGINS. <br /> <br />' FEHAI-,Ko~ SITE EVAL APPROVED STD'SYS <br /> I)ONAL. I) E., WOODLEY~ MARION COUNT~ BUILDING OFFICIAL B~ .................................................~_ <br /> <br />OFFICE COPY <br /> <br /> <br />