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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 226 <br />220 HiGH STREET NE <br /> SALEM. OREGON 97301 <br /> <br /> PHONE 588-5fl 47 <br /> COOE-A-PHONE 4:30 P.M,, ~ 8:00 A.M. <br /> <br /> The work wiJl be ge~formed by a registered bu der, <br /> <br />DATE; 0?/22/88 TIME= 3:40:51p <br /> <br /> HENSLEY. HARIE <br /> <br />, 14070 CESSNA ST <br />AURORA OR 97002 <br /> <br />................ 6~¥~5~16~ wP~ <br /> l <br /> <br /> 17585 I.,ANDURA CT NE .... <br /> AURORA OR 97002 <br /> PHONE: 982-4604 SITE NUH~ER: <br /> VALUAT <br /> <br /> ' <br />:w~0r~ 70 ~E'~H:: 108 <br /> <br />9009931 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERt~IT OR APPLICATION <br /> <br />CQqTRACTOR, NO. <br />HENSLEY, MARIE <br />17585 LANDUP-A CT NE <br />AURORA OR 9?002 <br />PHONE~ 982--4604 <br /> <br /> ZTEH <br /> <br />,,,AUTHORIZATION NOTICE - FL, D. VISIT <br /> <br />4986 <br /> <br />· zo~-: ......... AR iMAP"3 <br />i c0.~[./ ...... ~. .................. <br /> <br />NATER E~IPPLY: CH <br />TEST HOLES READY: <br />SITE EVALUATION NUiV~ER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES~ <br />SEPTIC TANK PUMPED: ?-20-88 <br />PREVIOUSNO, BEDROOm: <br /> <br />~I]ANTIT¥ AM~:XJNT <br /> 1 $105,00 <br /> <br /> $108.0o <br /> $0.00 <br /> $1o5.00 <br /> <br /> · .~333TAL ASSESSED,FEES <br /> : ,, P'REVZOL.~' RECEIP'~ <br /> <br /> ,'~ ~CE ~E $0.00 <br /> PAYEE: H~g~, ~[E ~ ,, '~/ . ~EIPT NO: 10~19 <br /> RECEIVED BY: ~ . ,. ~., ~PE. OK ~K n: 2333 <br /> <br />~l~ ~$T BE ~. I~lS~E ~ZBILI~ OF ~E ~PLI~ ~ ~ ~T <br /> <br /> ~~" <br />P~ R~I~: B~~ oAT CI~ JURI~DZ~I~; BY ~TE .... <br /> <br />OFFICE COPY <br /> <br /> <br />