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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-PHONE 4:30 P.M, - ~;00 A.M. <br /> <br />0ATE; 04./27/~8 TINE,. <br />I,.AI;~SEN, ~3YRC)N <br /> <br />75440-1~0 <br /> <br />DENT T AL <br /> <br /> 11576 MCCLELLAN LANE <br />AUM~VILLE OR <br /> <br />~&ARICN C~UNTY ~0 <br /> <br />SAME <br /> <br />PHONE: 769-7169 <br /> <br /> 80 120 <br /> <br />TYPE'- ON-SITE SEN,N~ <br />PER~4IT OR APPLICATION NO~ <br />CONT~'NCTOR, NO. <br /> <br />,~AME <br /> <br />PHONE: <br /> <br />SECTION TOWN~HIP <br /> 7200.00 <br /> <br /> TEN <br />AUTHORIZATZON NOTICE - FLD. VISIT <br /> <br />PAYEE: <br /> <br /> SITE <br /> VALUATION: <br /> <br /> 9S <br /> I~EG LOT <br /> SF NO <br /> <br />NATER SU~LY: <br />T~$T HOLE~ <br /> <br />~ISTIN~ T~K <br /> <br />SEPTIC T~K ~MPE0= WILL BRING <br />PR~I~$ NO, 8EO~ <br /> <br />g¢CuPANT ~Q,~ <br /> <br /> 2 <br /> <br />TOTAL A~SES,~ED FEF~ <br />PREVIOJ$ R6CEI PT~ <br />THIS RECEIPT <br /> <br />~AL.~NCE DUE <br /> <br />~TAYTON <br /> <br /> YES <br /> <br />~JANTITY ~NT <br /> $65. O0 <br /> <br />RECEIPT NO: <br /> <br />RECE[¥EO BY: JR TYPE~ ~HECK ~= <br /> <br />REMARK,~; F~9545 <br /> <br /> <br />