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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-PHC,NE 4:3Q P.I'¢.,- 8,:00 A.M. <br /> <br />DAT[: D6/22/~? TIME: ]1:33:50a <br /> SHELTON, DAVTD <br /> <br /> 140 HUMBUG <br />OETROIT <br /> <br />OR 9?342 <br /> <br />,; ....od N <br /> <br /> PHON~: <br /> <br />W~DTH; ! 2~' DEPTH; !00 AREA; <br /> TYPE: ON-S;TE <br /> <br />pE,%wif'F O~ APPLICATION NO: <br /> <br />CONTP. ACTOR, NO, <br />SHELTON, 0AV.i O <br /> <br /> ZTFJ'4 <br />S~TE EVALUATION, FI~T LOT <br /> <br /> SITE NU~ER.* 1 ?20 <br /> VALUATION: <br /> <br /> I 10~ 5E ~05 <br /> ! 2500. Ouu~T's: <br /> <br /> HATER ..~UPPLY: <br /> TEST HOLE3 READY: <br /> 9002767,., ~ITE EVALJJATION <br /> ,{ \ EXISTING TANK SIZE= <br /> ~ ~ EXISTING DRAIN FIELD LINE~; <br /> ,'~ / ~ ' SEPTIC TANK PUHPED: <br />/-~.~/~ PREVIOUS NO. BEDROOMS: <br />/,2 <br /> <br /> QUANT ~ TY A>IOUNT <br /> 1 $165,oo <br /> <br />TOTAL A~.~ESSEO FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />$0-00 <br /> <br />PAYEE: SHELTON, DAVID ZNVOICE NO: 3303 <br />RECeiVED BY, ~] TYPE: IN CHEOK <br /> <br /> ~ ~ V ~ ..... ;;,;. · ,' ¢,; %'.:: .' ," · ...... '"':'," <br />~[~,R~: ~ 2. "? "".'- ',' ", ~...F'.~( ,-'[;.:..'-:-C., ,, ,', : ,, <br /> <br /> <br />