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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 973o1 <br /> <br /> PHONE: ~88-5147 8:00 - 4:30 <br />24 HOUR CODE.A. PHONE: 588-7904 <br /> <br />APPLICANT;~¥ <br /> <br />LOT: <br /> <br />,WIOTH: <br /> <br />PHONE: 678-25S¢ <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERHIT OR APPLICATION NO: <br /> <br />¢,(J)l [F:hC7 Or,. <br />('}RF,'gDN F'L.O~ER'$ INC. <br /> <br />PHONE:: 67~-2~8~ <br /> <br />: ~ATER fiUPPLY: F'~ <br />I TEST HOLES READY: <br /> ~ITE EVALUATION NUMBER: <br /> ~XIST~NG TANK 8~ZE: <br />~ E~STING DRA~N FIEL~ <br />I SEPTIC TANK <br />I' PREVIOUS NO. <br /> <br /> Z TEN <br />,.~lI) Ol,hSITI~.] SYS < :~.00~.1 GAL <br /> <br />PAYEE: ORE[iON FLOi,$ER$ iNC. <br /> <br /> QUANTITY A~OUN'r <br /> <br /> TOTAL ASSE~SE~ FEES <br /> PREVIOUS REC$IPTS <br />'',THIS RECEIPT- <br /> BALANCE DUE <br /> <br /> F?~;[CEIVE]) BY: MB INVOICE NO.' 48404 <br /> =~ .... ====.. ~ TYPE: IN CHECK ~: <br /> SIdlE A'TTACHEO DOCUMENT FOR RE~UI~EflENTS OF ON-SI~E SEWAGE ~YSTEM. <br /> PERi, IT.' THIS AP~LI~ATI ~ ' R~ H A R E P C S ' E T <br />ALL tEEE..,..,AR, INFORMATION HAS BEEN.. PROVIDED.. <br /> <br /> I .M-Rx~. L[,M~ERL].A~ REPAIR <br /> <br />I:oR~ ,~ ~c o,s,~ ,~t~v. ,~J~<, OFFICE CO~ <br /> <br /> <br />