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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO 225 <br />'~20 HiGH STRF..ET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE; 588-5'147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE; 588-7904 <br /> <br />I na~o read and egree tO, th,s terms stated on the reverse side'oF DATE <br /> <br />WILLIAM <br /> <br />17:05:50 <br /> <br /> 11384 J.,N"'IES WAY <br />AU~V 1LLE <br /> <br />OR 97~25 <br /> <br />SE <br /> <br />f'IARJON COUN FY NO NO ¢' <br /> <br />AUFf-~V I L_LE 9"¢ 325 <br /> <br />NUMBER: 11551 <br /> <br />MAP <br /> <br />N,O ND <br /> <br />PERf4[l OR APPLICAfIQN NO: 9028248 <br /> <br />CON fRACIO~, NO. <br />L(Jt~G, HILLiAMI <br />l'/~O] ~fEiNK,NVlP' ROAO SE <br />AUhq~,ViLLE 97325 <br />PHONE: '749-~225 <br /> <br />WATER~PP~Y: <br />TE_~f HOL~ READY= NO ¢ t'~-i~WT~' ~ R~ <br />EXISTING F,ANK SIZE: <br />EXi$'IIN~ DRAIN FIELD LiN~: <br /> <br />P~i~5 NO. <br /> <br /> ,( F ~'¢'f QUAN7 <br />b,[ FB EVAL.UAtiON, ~. ADDL. LOT <br /> <br /> TOTAL ~ED FEE~ $145_ <br /> THIS RECEIPT $t45.00 <br /> BA~C~ ~E $0.0~ <br /> <br />PAYEE: L~G, WiLLI~ ,._~~ R~EiPY' NO: 29849 <br />RECEIVED BY: ~2 TYPE: OK ~ECK <br />~EE ATFA~ED ~ENl FOR R~iR~F~ OF ~-~["fE S~ <br /> <br />OFFICE COPY <br /> <br /> <br />