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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: 688-$147 8:~- 4.~ <br /> <br /> Other~ <br /> The work will be pedo~ed Dy ~ resistered ~uilder, <br /> t have read A~d agree to the terms stated ~ DA?E: <br /> <br /> DATE: 12/~6/~4 TIHE= <br /> ,. ....... ~, .................... · ................................ ~'~ ..................................... <br /> <br /> ...... }.__2 ............... ~ ......................... <br /> <br /> S~TE <br /> PHONE." 749-i822 '~ VALUAT[DN: <br /> .... J ....................................... <br />....................... & .... ; ..... L .... ~ ¢ j~_~:a._ .~. <br />~ ..... 3.~.~,, 1' ~_2 ........ ' ~ ~ ..' [..'~ .... <br /> TYPE.. OH-SITE SE~A~E ~. ~ATER ,SUPPk~ ..... <br /> ~' TE~ ,HOLES RE, DY= <br /> PEEHIT OR ~PLI~TIDN NO= ~877 f SITE EVALUATION <br /> I' EXISTING TANK SIZE= <br /> CASCADE ~NTERNAT[ON SEED COHPAN ~ SEPTIC TANK PUMPE~. <br /> .. - .............. , ,, j..PREVIOUS riO. <br /> PHONE: 749-1822 <br /> <br /> ITEM ":'; ' '" '" ': t3UANTITY AMOUNT <br /> <br /> · . ...... '~::::.- -~.', ,, ', .. ,..... · <br /> R~CEIVE~ ~Y~ JS ,TYPE: CK CHEC~ ~ 7~76~ <br /> <br />cOLLO~HG HUST ~E COHPLETED;.:'"-'Z,T'~S~.; RES~S}~L~TY'.'OF-THE RPPL~C~NT TO ~SSU~E THAT <br /> R~HARKS= SS= AUTH W/ V~SIT ~NEE~S PUHP~R F.ORH~ . <br /> <br />OFFICE COPY <br /> <br /> <br />