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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 22,5 <br />220 H~GH STREET N{~ <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: ~88~5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> PO 80× 848 <br /> CANBY OR 97013 <br /> PHONE: 266-27~2 <br /> <br /> ~0, llOi 9900.i BF <br /> <br />TYPEs ON-SITE SEW~OE <br /> <br />PERHIT OR RPPLICR¥~ON NO: <br />O0~TRAcTOR, NO, <br />~KOTNEKOFF, JOHN <br />PO B0X 84~ <br />O~NSY OR 970&~ <br />PHONE: 266-27~2 <br /> <br /> 95-00401 <br /> <br />i-~5~-~T .................... <br /> <br /> SUPP[ PW <br />TEST HOLE8 READY: <br />SITE EVALUATION NUMBER: <br />EX~STIN~ TANK SZZE: ~000 <br />EXIOTIN~ ORmIN FIELD LINES: <br />SEPTIC TAN~ PUMPED: <br />PREVIOUS NO; BEDROOMS: <br /> <br /> TOTAL ASSESSE~ FEES ~ ~-~ <br /> PREvious <br /> <br /> CONSTRU~ION FAILS TO'MEET ALL RE~U.IREMENTS OF 8TATE'L~S.~NO HAR~ON COUNT~ <br /> ED[N~flOES, 7WIS PERMIT SH~LL BECOME' ~0LL' 8ND.VOID. <br /> <br />/ (~RKS: H~OR REPAIR /8UBOT~NO~RD · <br /> O0~RLD E. WOODL~Y, H~R~ON COUNTY BUI'LOIN~ OFFICIAL BY <br /> <br />OFFICE COPY <br /> <br />// <br /> <br />280 <br /> <br /> (q~iOUH T <br /> $L05.oo <br /> <br /> $10,5. O0 <br /> $105. Or,) <br /> $0 .. 00 <br /> <br /> $0 ,, OO <br />~IL.,OING <br /> <br /> <br />