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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 />Other <br />t~-'¢¢, ~?~'~/0;I./93 T):NE: 11:011:42 <br /> <br />IMA[LING ADDRESS; SUSDI~I¢~'.~Jq ADPITt0N <br /> 5~20 NW E~TER ST <br />I VANCOUVER, ~A 7866~ ~ <br /> PHONE: 28&-.,695-~?C& ~ VAI_IJAT Z ON~ <br /> <br /> WIDTH; DEPTH: ~ AREA: UNITS; IRR~, LOT; COR,-BR; <br /> <br />PER.ZT OR APPLICATIOH <br /> <br />CONTRACTOR, NO., <br />JEFFREY ,~ CHASE <br />~J;~2e N~ ESTER ST <br /> <br />'I'EST HOLES READY: = -~ . <br />SITE EVALUATION NUH'[-)E~(~ 4~.~57;'~ <br />EXISTING TANK SIZE: <br />EXISTIN6 ~RA~N FIEL.~ LINES: <br />SEPTIC TANK PU~PED: <br />PREVIOUS NO. BEDROOMS: <br /> <br />ITEM QtJANI']:'T'Y AMOLtN f <br />SEI.;:.PAI.;E TRENCH ES :1. ~§:: ~ <br /> <br /> I AYEE,, INVOICE ~0: <br /> RL-.I,,E1VE'D BY: MB ...................... , .......... =~. ......... ~YPE: ;NEC, K ~: 0 <br /> <br /> SE~-. ~"T~C~g DOCJMENT. FOR REQUIReMENtS ..... ~F O~-~.~T~'S- ~OA-~G: ~YST~ ~ ..... H. <br /> <br />F(t,t. OW] qG MLST BE [OMPLETED.:,¢ IT:,~D~,T4E 'RES'PONSIB1L~Y DF THE APPi ICA~T TO ASSUR'E ",,~A'T' <br />ALL I,IE~ESSARY ~NFORMAI'ZON,HAS' BEEN PROVI,~ED. ........ <br /> <br />F'LAN RE;V:[EW: ~Y ..................... DATE <br /> <br />RI:.MAI-dx,~,, SIFEPAGE TRENCH SYSTEN <br /> <br />C]:TY JURIS:OZCT]:ON= BY ......................... I)A'TE .......................... <br /> <br />roRu # MC ~S-S~ R~V, ~mo OF FICE COPY <br /> <br /> <br />