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MARION COUNTY BUILDING iNSPECTiON
<br />SENATOR BLDG. NO. 225
<br />320 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br />PHONE: ~8~5147 8:0(3- 4:30
<br />HOUR CODE-A-PHONE:
<br />
<br />~-(~E~e*re~n~{re~to the te~ ~tSte~t~m~eme 6ide ~ OATE; ..........................
<br />DARK, JOHN RESIDENTZAL
<br />owN~i ........................................................................... ~-L~T .................................. 6Xf~on~"
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<br />.................. ~.-~-~ ............... ;,. _ ~E ..................................... ~ ~ .........
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<br /> P~ECEL ~ THE ~ANCH
<br />
<br /> PHON[: 7~9-5~6& , ' VALUATION:
<br />
<br /> 28 8$ ~ 1W AR 48
<br />
<br /> E: ~- 'SEU~E , , WATER SUPPLY. PW .
<br /> ~ :: ~ ;: -~,,,:, ~ -~-~QL~R~--~. ....................
<br /> SITE EVA~AT~ON NUMBER:
<br /> CONTRACTOr<. ilO. 36415 J EXISTING DRAIN FIEL~ LINES~
<br /> CHARLEY HESS BACKHOE : SEPTIC TANK
<br /> PREVIOUS NO.
<br />
<br /> ~TE~ ~UANTITY AMOUNT
<br /> SITE EVALUATIOH~ FIRST ,~OT ..... · 1
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<br /> "' TOTAL AS~ESSEg. FEES
<br /> ., · ' PRE~tOU~ RECEIPT~
<br /> ...... .'~ .THIS-:~ECEZPT.. . . ',' .
<br /> ,,,,,. .... ~,~
<br /> '"' .......... BA $~.
<br />
<br /> PAYEE: ". ......
<br /> EE~E~VE9 9Ya c~ . , :: .... ,,, ".' ,..:',,....,~..-:'.'.' '.: ;,;-, ,, RECEIPT
<br /> .............. ~ ....... ~-,~m~;;_;;~__~;.;..~;,., ,, TYPE~ CHECK t:
<br /> SEE ~TT~OHED ~OCU~ENT-~,_
<br /> ..................... ~---~... :, ,~',;,, 77-'~-77. , ,,, - ..................................
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<br /> PARCEL.
<br /> ONSTRUCTION :. I ';' ,' ' ~ '~ :' ,'.," PTIC INSTALLATION
<br /> PLANNING A~D
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<br />OFFICE COPY
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