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MARION COUNTY BUILDING INSPEC1;ION <br />SENATOR BLDG, NO, c,25 <br />220 RialS'STREeT NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 5@8-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />E~IGNATtJR~ OF APPLICANT ................... <br /> <br /> DATE;, ,,~ .................. <br /> <br />P.O. BOX ~77 ? <br />~ O[T~IT, OR 973~2 : <br />' ~E: ~ siTE NU~ER: 13089 <br /> <br />PERMZT OR APPLiCATiON NO*. 9052506 <br /> <br />P,C, EOX 465 <br />OET~ZT, OR~ 973~2 <br /> <br /> ITEM <br />5TANOARO CI~-~ITE E~Y~TEN <br /> <br />WATER ,SUPPLY*. <br />T~'r HOLES READY.' <br />SITE EVALJjAT I C~ <br /> <br />~I~Ti~ <br />SEPTIC T~K <br />P~i~S NO, <br /> <br /> $185.00 <br /> <br /> $~65.00 <br /> $0_oo <br /> <br /> So.Do <br /> <br />3~2S? <br /> 0 <br /> <br /> PAYEE: KEV[,N'5 BAq~HpE ,~ERV[CE.'. ' , ' '" "' INVOICE <br /> RECEJVE~ BY. pm ~ .' . " .' · . TYPE: iN ~ECK <br /> SEE A'r'r~6O ~M~'F ~R RE~IR~'~ OP ~-Si'~E '3~E S~T~ <br />;- ...... ?.~ '~ ......... ~ ........... , ..... . ............... <br /> <br /> R~R~: SEPTIC 1NSTAL~TI~ ':"' <br /> <br />OFFICE COPY <br /> <br /> <br />