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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOC NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 (~;;00 - 4-:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> ..q <br />~ ha.¢ re~ ~ ~fj~ee ~'thq~er~ ~tet~ on ~"e re-erie ~ide Of <br /> <br /> 11115 J/V,1E~ NAY <br />AUH'-JVJLL~ <br /> <br />OR 97305 <br /> <br />SE <br /> <br />I~kRi ON ~N'¥'Y <br /> <br />NO <br /> <br />P.O. BO× 632 <br />~'IAYIONz OR g7385 <br />PHONE: <br /> <br />CAI~,~LLiA HEiCqHIS ~3 <br /> <br /> SiTE NUI'C, BERt 12539 <br /> VALUATION: <br /> <br />2.7 AC NO NO <br /> <br />MAP <br /> <br />I'YPE: (]N-$IIE SEWAGE <br /> <br />P~f,t~[[ OR APPLiCA[iON NO: 90W1028 <br /> <br />WATER SUPPLY: ~ <br />1E.~51 HOLES READY~ <br /> <br />~,~iS~ING lANK SIZE: <br />EXISTING DRAIN FIELD LiNES~ <br />SEP'I[C TANK PU~P~b= <br />PREVIOUS NO. BEDROOi~: <br /> <br /> TOTAL ASSESSED FEES <br /> PR2VIOJS RECEIPTS <br /> THiS RECEIPT $16b,~D <br /> <br /> ~ALANCE OU~ $0_00 <br /> <br /> PAYEE: YCL~MANS, ~I~ RgCEiP7 <br /> RECEiVE~ BY; PR TYPE: CK <br /> <br />* THIS IS ~T A ~IT. THI~ ~PLi~TI~ ~T ~ ~ A R~i~ P~ ~ERE THE <br />~L~ING ~5~ BE ~T~. IT l~ THE R~SlBILiTY OF THE ~PLI~T TO ~IRE THAT <br />~L N~RY IN~Ti~ H~ B~ <br /> <br />REJ~ARKb: 5EPIIC iNbTALL.AI'IC~ R~352B <br /> <br />CITY JURISD1CTiON; 8Y .......... OA~ <br /> <br />FC~ ~ MC ,,~-U~ R~v ,~Jo OF F ICE COPy <br /> <br /> <br />