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MARION COUNTY BUILDING iNSPECTION <br />SENATOR BLDG, NO- 22S <br />220 HIGH STREET NE <br /> SALEM. OREGON 9¥301 <br /> <br /> PHONE <br /> CODE-A-PHONE 4:30 P.M. - 8:00 A-M, <br /> <br />I em ~ regletefea builder OR { ) the authorized ~greeentative ~IQNATURE OF AP~LI~NT: <br />of a registe~ ~uUder. <br /> <br /> :J??2 LEVE¢C4AN ROAD <br /> <br />;>HONE: 749-1~19 <br /> <br />WIDTH: ~E~H: <br /> ~7 <br /> <br /> TYPE: ON"G[TE Si~E <br /> <br /> PE.~T OR APPLICATION NO: <br /> <br /> CONTRACTOR, NO. <br /> ~IL~, VIvI~ <br /> ';~?~2 L~VE~ ~A0 SE <br /> .~MSVIL~E 97325 <br /> PH~E~ 7~g-1319 <br /> <br /> I SiT~ NUM6ER: 3 '~. 75 <br /> ............... £ ........... ..v..~:M(,...-..~_! <br />...... ~ ....... ~ ..................... ~s_..! ............... ~. ......... ; .................. <br /> <br /> HATER ~PPLY: <br /> T~T HOL~ R~DY= Y~ <br /> ~ITE ~A~ATI~ NU~ER: <br /> <br /> ~STING O~IN FIELD <br /> . CEPTIC T~K <br /> <br />~0~¢ · ~c .- Rev. e/e? OFFICECOFY <br /> <br /> <br />