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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-$147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> / <br />I have read an0 agree to the terms stated on the reverse sl0e Of 0AY$~ ,,, ~ ~.~¢ ~---~ <br /> <br />owN~ CA'[E: 03/22/g~ <br /> <br /> R i CHARL~. STEVE <br /> <br />1 2; 4~: 26_. <br /> <br /> 10273 WISEACRE LANE <br />AURORA OR 9?002 <br /> <br />TYPE <br /> <br />NE ' ~6NT'~ACT 6~TY: ......... l'""~ ~: <br /> MAR J0N CO~NI:Y <br /> <br />NO I <br /> <br />6060 ,~ 1877H PL <br />ALC3~A OR 97007 <br />¢qir..X~l £: 649-6152 <br /> <br />IYPP: (~N-~IIE SEWAGE <br /> <br />PERMiI' OR APPLiCAI ION NO: 9031090 <br /> <br />WK~526-5O90 <br /> <br />CCNTRAC]OR, NO, <br /> <br />5060 E~/ 187~H PL <br />ALOHA OR 97007 <br />PHONE: 549-6152 <br /> <br />I '¥' E~I QUANT 1 'FY AMOJN [ <br />FILLER 1 $300_D0 <br /> <br /> TOTAL ~ED FE~ $300,00 <br /> PR~I~S RECEIPTS $0.00 <br /> THiS RECEIPT $300.00 <br /> <br /> ,, ~.~,0.0O <br /> PAYEE: Ri~ARL~, $'IPYE RECEIPT NO: <br /> RECEIVED ~Y; ~ ~ · . ": ._ IYPE~ CK ~ECK ~: 481~ . <br />.......... _ ..... .... . ......................... <br /> 5~ At ~A~ED ~MENI' ~R RE~[~T~ OF ~'-SiTE '$~E S~TEM. <br />~ l'HIS IS ~T A ~IT. THIB APPLI~Ti~ ~ST ~ TH~ A R~[~ p~ ~HE <br />~LL~ZNG ~S~ BE ~P~T~. IT ~S T~ ~iBiLI~ OF THE APPLi~T TO ~RE THAT <br />ALL N~RY iN~Ti~ ~ B~ P~IDED. <br /> <br />PLAN REVIE. W: BY ................. DAlE ................... Ci1Y JURiSDICIiON: BY ........... DALE' <br />REMARKS~ SANO ~',[L')'~ 5Y'S'¥~ R~5904 <br /> <br />rO~,~ ~C ~ ,~ r~Ev ,~ OF FICE COPY <br /> <br /> <br />