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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOC. ~O, 225, <br />220 HIGH STREET NE <br /> SALEM, OREGON g7~01 <br /> <br /> ' PHONE $88-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M, <br /> <br /> of a r~stered builder. <br /> <br />3ATE: 07/]¢/87 <br /> <br /> 852i HO'~!ST RD SE <br />AU~V[LL~ OR g7325 <br /> <br />~ TAX LOT: .... ?C,k~GORY: <br /> 55351 -~ 1 $ ~ :,:E~. ~EN, .~,A.,, <br />'! ~ONS?~bCT~ON ~,~; :OCCUPANCY: <br /> <br />' UsE OF IB~JILIDIN~: .... <br /> <br />'~4~d~¢ ^ooae~: ' ...... <br /> <br /> ITF~V~ <br />PRESE~JRE DI~TRIBUTI ON <br /> <br /> PAYEE: GOD{;)ARD, <br /> <br />5E£ ATTACHED F.X.~;Uiv~ENT ?CR <br /> <br />* THIS IS NOT A PF-R~IT. THI.~ <br />FOLLOWING I~JST BE CO~IPLETED. <br />ALL NEC~RY INFORMATION <br /> <br /> SITE NUF~ER: ! <br /> i VA_UA .,ON <br />SECTION:' "~ '~i~, L ........... ~G~.: .... <br /> <br /> 2.86000 . AC N0 ~ NC <br /> <br />~003222 <br /> <br />NATER ~I. JppLY: ~ <br />TEST NOLEE, R~ADY-, <br /> <br />~ISTING T~NK S~ZE: <br />~IGT~NG D~N F;ELD <br />GEPTZC T~K PUMPED: <br /> <br />QUANT I Tv ..*J~J;.INT <br /> <br />TOTAL"AS~D ~Ei$ <br />P~EVICU$ ~ECE~P~S <br />THiS EE"CE~PT <br /> <br />BALANCE DCE <br /> <br /> INVOICE NO: <br />T~P~: CK CHc.~K <br /> <br /> $C,JO <br /> <br /> $c.00 <br />~759 <br /> <br />PLAN RE~'iEw: BY V~/}' <br /> <br />R,-'~i~.ARK$: LOJ4 PRES,~RE <br /> <br /> <br />