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MARION COUNTY BUILDING INSPECTION
<br /> SENATOR BLDG. NO, 225
<br />.~.. / 220 HIGH STREET NE F I L E
<br /> SALEM, OREGON 97301
<br />
<br /> , . . , . .:.., .: : 'PHONE..'iSS~5147'[x,~8_ODL4:30 ..... ,,,:.., ', ...... ,... , ,, ,:= ,.,. , :
<br /> " ' ..... ' 24 HOU,.R,I~O.D,'ET.,A)'PHONE ~7904'''r: ~"~, ' ' ' '., ,'.,,",~: , ·
<br />
<br />The workw [beperfofmedbyeregsteredbu der.,,' .... ., '' .' , ' · , ' · .
<br />o ~ ....... ' ...........J'"" ......' ~'r~ ' ' ' ~
<br />
<br />USSELHAN, ~. & H. 7~B1-~5~ ~RE~DENTIAL
<br />
<br /> .;;, ,: ,. . ;, , , -~..~ ~ [..% ,',,',,,',~,,~.. ..~ ,'
<br />
<br /> 3015 $TARR CT NE
<br /> SALEM OR 973~3 ~ ~I~E NU~. 94-~1912
<br /> PHONE~ 58B~399 ~ VALUATION:
<br />
<br />TYPE= ON-~ITE
<br />PERMIT OR APPLICATION NO=
<br />CONTRACTOR, HO.
<br />U~SELNAN~ ~. & H.
<br />~015 STARR CT NE
<br />SALEM OR 97303
<br />PHONE: 588-~379
<br />
<br />WATER SUPPLY: PW
<br />TEST HOLES READY= YES
<br />SITE EVALUATION NUHDER:
<br />EXISTING TANK SIZE:
<br />EXISTIN~ DRAIN FIELD'LINES:
<br />SEPTIC ~ANK PUMPED:
<br />
<br /> II'EN
<br />SITE EVALUATION, EA.
<br />
<br /> PAYEE: NICOLL
<br /> RECEIVED By:
<br />
<br /> SEE ATTACHED ~OCUNENT
<br />
<br /> NOTE: THIS DOES NOT
<br />ONSTRt$CTION PERMITS MU,
<br />
<br /> PLAN REVIEW:
<br /> REMARKS~ SS:SE:TH:REA~Y,~.INOR~RTII~0N
<br />
<br />QUANTITY AMOUNT
<br /> 1 ~225.~0
<br />
<br /> $225.00
<br /> $0.80
<br /> $225.80
<br />
<br />$0.00
<br />
<br /> RECEIPT NO: 57505
<br />TYPE: CK CHECK ~: 2445
<br />
<br />~YSTEM.
<br />
<br /> 'THIS PARCEL, PLANNING AND
<br /> INSTALLATION BEGINS,
<br />[CTION: BY ......... ~ATE .................
<br />
<br />OFF[CE COP~'
<br />
<br />
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