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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIG~q ~TR~ET NE <br /> SALEM, OREGON 9730% <br /> <br /> PHON. E ~88~5147 . <br />CODE-A-PHONE 4;;30 P.M. - 8:00 A.M. <br /> <br /> Other ......... - <br /> <br />OATE~ 0~/08/8'7 TIME: 12:25:10p <br /> <br /> ME.~KERS. MARTIN N. <br /> <br />DATE; <br /> <br />40548-000 <br /> <br /> 20747,,Hi~HWAY 9~gE NE. , ' ' 4~I:~I~TRAOT CITY; <br /> AUF~OR ' ' ':'OK "'9?002' .... <br /> <br />~,U,G ^oon~$a~ RE$)Di~TIAL ACCE'~..e~OI:r'f STRUCg~R_Eo SU~OIVI~N: <br /> <br />AR: <br /> <br />a~a NO, ~AKER ORIVE <br />CANGY, OREGON 6?8-2580 <br />~0NE; 266-¢!43 <br /> <br />~PE; C~-3ITE 3EWAG5 <br /> <br />13 <br /> <br />PEr~,u-r OR APPL~C~TZON NO~ 1'~5~ <br /> <br /> ~TE NU.~ER; 1211 <br /> VALUATIC~: <br /> <br />4S IW .AR <br />SF N N <br /> <br />WATER ,~JPPLY: ~ <br />TEST HOLES READY: ARE C~JG <br />~ITE ~VALUAT[ON NU.N~ER: <br />~ISTING T~NK SIZE: <br />~ISTING D~!N FIELD LINES: <br />SEPTIC T~K ~MPED: <br />~OLDING T~K AGRE~T: <br /> <br />AFF[~VIT: <br />WINTER WATER CHECK: <br /> <br /> .' T~I QUANT I TY ~?x"JLiN T <br />SE < 8 MONTHS OLD ~ $65. O0 <br />,~ITE ~ALUAT~, FI~T LO_~ , ~t ~ <br /> TOTAL ~E~E~ FEES $230_~0 <br /> PR~IOUS R~EIPTS $230,00 <br /> ~IS R~EIPT $0.00 <br /> <br /> ~A~CE ~8 $0, O0 <br />PAYEE: INVOICE NO: <br />'.qECE~VEO BY: ~ ~PE= CHECK ~: <br /> <br />~ ~I~ ~ 0~' ~"'~-.'~I~' , ' , "'""':" 'TO~,~'~','~" ' ' ' ~EL. ~I~ ~ <br /> <br />RE~ARK3. OLES ARE ~ <br />;~ALD ~. ~DLEY, ~R[~ C'~N~'BUILDING' ' "' "OFF~C'[AL" ....... / ~y ~ <br /> <br /> <br />