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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 />I am De orm ng work or~ · oro~erty I OWn or oCeUl~¢, ^NT _..~_v_~.~ .~. <br /> <br />AU~VILL~ O~ 9?325 <br /> <br />~gt, lE: 7Ag--251'f <br /> ? <br /> <br />PE~IF OR ADPLICA'F[~ <br /> <br />c~ r~TOR, ~. <br /> <br />~E: 749-2517 <br /> <br />R~PA[ R - <br /> <br />AREA:;" ~,7'6'20' dNfYS <br /> <br />9025610 <br /> <br />DATE <br /> <br />- ~;AX LOT: CATEGORY, R~I DEN I ,[ <br /> <br />¢ONSTI~UCTIO N TYPE <br /> <br />fi~.AR J. ON QQUNTY NO <br /> <br />NATER.ELJPPLY: F~ <br />TE~T HOLE~ RFc. ADY: <br />SiTE EWALUATION NUNSER: <br />EXiSTIIh~ T~ 5IZE; 1000 <br />~i~TiN~ D~iN FIELD LiN~: <br />~EPTIC T~K ~MPED: <br />PR~t~ NO, 6~0~ <br /> <br />C,~J~NTiTY <br /> 1 <br /> <br />$8o.oo <br /> <br />THIS RECEIPT <br /> <br />$0.00 <br />$60,00 <br /> <br />- ~ALANCE OUE $0.00 <br /> <br />PAYEE; 874GLAND, JAM~ W. RECEIPT NO: 2'?t22 <br />RECEZVE0 BY: PR TY~: CK ~K ~ 25'12 <br /> <br />............ . .... <br /> <br />FOLLO~iN8 ~T BE ~ETED. iT l~, THE R~i3tPON~IBILiTY O¢ THE APPLICANT TO ASSURE THAT <br />ALL N~RY ,[NFORMATICI~ HA..~ BEIB'¢ PROVIZ. <br /> <br />RIC4ARK,S: REPLACE, DRAINFiF_LD ~:2620 <br /> <br />CITY JURI3DICTiON~ ~Y ................ DATE ................ <br /> <br /> <br />