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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 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A_M. <br /> <br />DATE: 08/24/8? TIME: <br /> STC~N ER, M. <br /> <br /> ~ FILBERT STREET <br /> <br />DA'rE: ....... <br /> <br />~HONE: 678-5497 <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />STONER. M. <br /> <br />PHONg: 678-549? <br /> <br />SITE EVALUATiON, .FI RST LOT' <br /> <br /> SITE NU~ER: 2166 <br /> VALUATION: ' <br /> <br />,"~ ~...~ " ~ u.,~: ................ ~ ..................................... ,...~, ~o,: NO ~6 ~ ............ <br /> <br /> ~T~ ~PPLY: ~ <br /> T~T HOL~ <br /> 3712 'S~TE ~A~TI~ NU~ER~ <br /> ~IST[NG T~K SIZE: <br /> ~IST~NG D~IN FIELD <br /> SE~C T~K <br /> PR~ NO. BED~ 0 <br /> <br />S <br /> <br />QU~NTI TY <br /> 1 <br /> <br />AMOUNT <br /> $165.00 <br /> <br /> ~165.00 <br /> 155.00 <br /> $0.00 <br /> $0.00 <br /> <br /> " "BALANCE DUE ;';',, <br />PAYEE ~ <br /> <br /> 8Y <br /> <br />,'¢.~ ,, ~c ~*.*~ .~v e~e~ OFFICE COPY <br /> <br /> <br />