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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIG~TRE~T NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-51;47 8:00 - 4;30 <br />24 'HOUR CODE-A-PHONE: 588-7904 <br /> <br />Omer <br /> <br />RIE~TERER,. 8 ERN_A~D ...... <br /> <br /> 8521 HOL~..4X. JlST RO <br />AUFrSV[ Lt.E <br /> <br />RES i D6N'r ! / <br /> <br /> ....... ~LOOD~LA[N, · <br />P,O BOX 255 <br />~JSLI~ITY, OR 97385 <br />PHONE: 7§9--2139 SITE NU~ER: 190~ <br /> V~A~ [~: , <br /> <br /> = ~.86 L ............ ~,, ~ ~ ~ NO <br /> <br />MAP; <br /> <br />48 <br /> <br />TYPE= CN-$ZTE <br /> <br />PERf4IT OR APPLiCATiCe~ NO= <br /> <br />CONTP. ACTOR, NO, 35916 <br />5TAYT~ <br />41155 STAYT~ <br />STAYT~, OR~ 97383 <br />~E: 769-2302 <br /> <br />WATER SUPPLY= <br />TE~ST HOL~ READY: <br />SITE EVALUATION NUF~ER: SE83-1950 <br />EXISTING TANK SIZE: <br />I~XISTING DRAIN FIELD <br />~PTIC TANK PUMPEO~ <br />pREVIOUS NO. <br /> <br /> ITEM <br />PRES.SURE DISTRIBUTiON <br /> <br />PAYEE= <br />R~CEIVED BY: CL <br /> <br /> TOTAL, ~D FEES <br /> PREVIOUS' R.ECEI PT*~ <br /> THIS RECEIPT <br />, BAi.~d~:E'DUE <br /> <br />~U.NqT,[ TY <br /> 1 $165~00 <br /> <br /> ~165.00 <br /> 165.00 <br /> $o.0o <br /> <br />$0.00 <br /> <br />RECE&PT NO= <br />TYPE: CHECK ~: 0 <br /> <br /> SEE ATTACHED DO;UMENT FO~ RE~JiREMENTS O@ 0N-~SITE S~E ~. <br />~ 7Hi~ 15 A V~[O ~IT ~ THIS ,~IT ~l~ 360 ~ F~ iTS I~E ~TE. IF <br />Z~I~ ~IN~, THi5 P~IT .~L ,B~E ~LL ~D VOID. <br /> <br />RENARt~ PR~-~qIRE DISTRiBUTZON R~3311 <br />~NALD E, I~3OOLE¥, ~RiON COUNTY ~U[LOZNG OFFICIAL / DY ............................................................~ <br /> <br />OFFICE COPY <br /> <br /> <br />