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MARION COUNTY I~UILDING INSP£CTION <br />SENATOR ~.LDG~ NO 225 <br />22'~ HIGI~ STREET NE <br /> SALEM~ OREGON 97301 <br /> <br />DATE.' 07/26/0g TIME: 10:07:52a <br /> HURLINAN, MARCEL JR <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONI= 4:30 PM. - 8 00 A.M <br /> <br />i0429 CHAMPOEG RD <br /> <br />OR 97002 <br /> <br />NE <br /> <br />W,UrH 0~m. ~A 5 - / ~g000u~rr~ <br /> <br />40264-000 c^T~o.Y I[SIOENTb <br /> <br />COUNTY NO <br /> <br /> SITE NL)~I~ER: ?'919 <br /> VALUATION: <br /> <br />tS 1H E~J <br />AC ,~6 ~¥ NO c°~"~nNO <br /> <br />TYPE: ON-SITE SEk~GE <br /> <br />PERNIT OR APPLIC.~TION NO: <br /> <br />OONTP, ACTOR, NO. <br />~gRL~, ~EL JR <br /> <br />9017566 <br /> <br />HATER SUPPLY: <br />TE~T HOLE3 READY: <br />SITE EVALUATION NUMBER: <br />EXISTINGT/~N~ SIZE: <br />EXISTING DRAIN FIELD LIN~: <br />SEPTIC T/~NK PUMPED: <br />~REVZOUS NO. <br /> <br />PHONE: 678-5071 <br /> <br />REPAI~ - MAJOR <br /> <br />s> <br /> <br />PAYEE; HURL~MAN, MARCEL JR <br /> <br />TOTAL A,..~SEExSED FEES <br />PREg/I CXJ$ REC~I PTS <br />~Z$ RECEIPT <br /> <br />$@0.o0 <br /> <br /> RECEIPT NO, <br />TYPE: CK CHECK <br /> <br /> $80. O0 <br /> $o.oo <br /> $80,00 <br /> <br /> $o .oo <br /> <br />!8759 <br />2~96 <br /> <br />RECEZVEB BY: ¢9 <br /> <br />SEE ATTACHED DOOUM~NT FOR REQU,I~t~'gT'~ OF ~-S:TE S~a~ 8~TB, <br />* ~zs m . ~s.~z~T~~ ~T ~ ~ ~ ~ ~ <br /> <br />ALL N~ IN~Oi4t, IATION HA~ 8Et~ I:N~DVIDED. <br />REMARKS: h,lw~OR REPAIR <br /> <br />CITY JURISDICTION: BY <br /> <br />DATE <br /> <br /> <br />