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MARION COUNTY BUILDING INSPECTION <br />~ENATOR E~LDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM. OREGON 9'7301 <br /> <br /> PHONE: 588-514.7 8',00 - 4:30 <br />24 HOUR CODE-A-PHONE: $88-7g04 <br /> <br />i°w"i~'~i" GAGATKO, DONALD J. <br /> ................... , .............. . CONSTRUCTION <br /> <br /> 350 ~T'F AVE ~ ~'6h~'b{~ ....... ~'~ ..... ?ccu~,~ ~oAo: <br /> OET~I T OR 97342 <br /> <br /> P&TT~ 2ND ADD[T[~ <br /> P.O, ~ 577 ............................................................. <br /> <br /> VA~AT [~: <br /> <br />TYPE: (.1~-,.%1¥E E. Eb/AGE <br />~F~'r OR APPLZCA'FION NO.- 32505 <br /> <br />CONTRACTOR, NO. 35421 <br />KEV.tN ' ,,% BACKHOE $~RV$CE <br />P.O. EIOX 465 <br />DETROIT, OREG'C~ 9?5'42 <br />PHONE: <br /> <br />HATER ,!~JPPLY: CH <br />TEE)T HOLE~ READY: <br />SITE EVALUATiON ~ER: <br /> <br />~ISTI~ ~IN FIELD LiN~: <br />5EPT1C T~E ~MPED: <br />PR~I~ NO. 8EO~: N/A <br /> <br /> I TEN QUANT I TY <br />S'FANDA~D ON-DI'rE ~YSTEhl <br /> <br />$]65.oo <br /> <br /> 186,00 <br /> $0.00 <br /> <br /> TOTAL, A,DE, ES~ED FE~:S <br /> ,, PREV, I OUE, RECEIPTS <br /> ' ' ' THI~,..'R~EiPT. <br /> <br />PAYEE: "' ' ' I IINVOICE NO: <br />RECEIVEO ~Y~ CL T~E: ~ ~: 0 <br /> <br />~EE ATTA~EO ~N~'r FOR R~IR~3 OF ~ITE <br /> <br />RI~,!,ARK~: ,~EP'i"IC iNSTALLATiON <br /> <br />DONALD E. t,~ODL~, MARzON",COUNTY BU,'[I. IDING OFF. J~CIAL / By <br /> <br />OFFICE COPY <br /> <br /> <br />