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MARION COUNTY BUILDING iNSPECTION <br />,'~ENATOR ~LDG. NO, 228 <br />~ HIGH'STREET NE <br /> SALEM, OREGON 9730~ <br /> <br /> PHONE 588-51a,7 <br />CODE-A-PHONE 4.30 PM - 8 00 A M. <br /> <br /> TIME: 1 t20=40p <br />MARCEL JR <br /> <br />40264-000 <br /> <br />RE~I' DENT I <br /> <br />I~3429 CHANPOEG RD <br /> <br />OR 97002 <br /> <br />N~ <br /> <br />NARION COUNTY NO <br /> <br />SANE <br /> <br />TYPE.- (~N-~ITE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTEACTOR, NO. <br />HURLIIKNN, MARCEL JR <br /> <br />PHONE~ 678-5071 <br /> <br />REPAIR - MAJOR <br /> <br /> 6 <br /> <br />5. ?go00 <br /> <br />17666 <br /> <br /> ,15 <br /> AC NO <br /> <br />MATER .~.JPPLY: <br /> <br />SITE NUMBER: 7919 <br />VALUATZ CN: <br /> <br /> EFU <br /> <br /> NO <br /> <br />TEST HOLE~ READY: <br />SITE EVALUATION NUNSERt <br />EXISTING TANK SIZE: <br />EXISTIN~ DRAIN FIELD LINES: <br />~EPTIC TANK PUMPED: <br /> <br />TOTAL AE~ES,~ED FEES <br />PREVIOU~ RECEIPT~ <br /> <br />t~ALANC~ t3JE <br /> <br />(~ANTITY ANOUNT <br /> 1 $80.00 <br /> <br /> $~0.00 <br /> Sa0.00 <br /> $0,00 <br /> <br /> $0,00 <br /> <br />PAYEE: "" RE. CE[PT NO: <br /> <br />RECE:vED DY: dm ........ <br />SEE ATTACHED ~T FOR RF.~l~;~,;m,OF <br /> <br />REQU~ OF ~TATE[ LAN~ AND 1~4ARZC3q COUNTY 8UI'LOZN& AND <br /> <br />REMARKS: ~tAJOR REPAIR R~7629 <br /> <br />DONALO E. ~)OOLEY, NARION CC~JNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />