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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 /> ! CONTRACT DITY: UGS: i ODOUPANT LOAD: <br />WAY DI;", S~: · <br /> <br />MAIblNG ADDRESS: <br /> <br />SITE <br /> <br />69141 <br /> <br />WATER ,,SUPPLY~ F'W <br />TE'ST HOLES READY: <br /> <br />EX][SII!,IG YANK S[[ZE',', <br />EXISTIN~ DRAIN Fi[ELD I,.,Zi',~ES: <br />SEPTIC TANK PLi~PgD: <br />PREVIOIJS NO,, BEDROOMS: <br /> <br /> ]'TEH <br />;<×.t:S l']],l[:; ~ ' :"',:"~ <br /> , ~. ,n E:VAL. D, Pf, <br /> <br />TSTAL AS~J <br />r,~E ¢IOLIS R~,OE,.F <br />TH]/8 RECEIPT <br /> <br />GII.IANT L[ T Y A H [] Ui,',";' <br /> <br />BAt A~ CE I)UE ' ' <br /> <br />P(;YF'[:,;; RECE:[PT I O. <br /> <br /> L :-:... /..D ~Y~! L.L, TY~%'5,", [,HE,,,', ' ';:) <br /> ,,: ¢'l~h.,l(-,~) !),r,)l:;bM~:HT FOI~ P. EI:~U,f.R!~;Ht~:NTS OF OH-~S:Ii'FE SEWAGE <br /> <br /> * ,?-~Z$ ~$ A VALID PERMIT ~ TNIS PER~IT EXPIRES :~&e DAYS FROM ITS ZSSUE DATE. IF <br />Cd!,/!.¢~!(UC'~,'.~.O!,f !~,.A,,71.~S '~f] NEET ALL RE~UIRE:HE:N'~S OF STA'f% LAWS AND NAR~O~,~ COUNTY 3::Z',.,D]'n";. <br />~r)~L':N~,. ORD'.[~,[AHCE'3~ 1H.l'S PERMIT SHALl.. ~ECOHE: NULL AN~ <br /> <br />,' .... 0I TY JC~J.~L.~,l~ 0~i~C;[(AL / ;BY . ................................................... <br /> <br />OFFICE COPY <br /> <br /> <br />