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MARION COUNTY BUILDING INSPECTION
<br /> SENATOR BLDG, NO. 225
<br />' - ' '~20 HIGH STREET NE ,.
<br /> SALEM' OREGON 97301F t !:~,,. E /
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<br /> 1 am a ~egi~tered builder 0~1 ( ) th~, au%hori;~e~
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<br /> The wc~tk will 13e ~,edotmed by a regi~e~e~ builder.
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<br /> 2~757 CASE RD
<br />AURORA
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<br />SAME
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<br />PHONE= 678-5@9~
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<br />SITE NI.,q~ER= 94~3942
<br />VALUATION=
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<br />AREA;
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<br />TYPE." ON-SITE SEM~F#E
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<br /> ~ATER SUPPLY: PW
<br /> TEST HOLES READY:
<br />9~77~ SITE EVALUATION NUM~ER:
<br /> EXISTING TANK SIZE:
<br /> EXISTING DRAIN FIELD LINES:
<br /> SEPTIC TAN[ PUNPE~ NO
<br />" '' .... ,'"PREVIOUS NO~"BEDROOMS=
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<br />P~RH~T OR APPLICATION
<br />CONTRACTOR.
<br />AREWDT~ LARRY
<br />SAHE ,,,
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<br />PHONE=
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<br /> AUTND TION NOTICE -.FL~,~ VISIT ' ' 1 $160.0~
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<br /> ,, ,' , ':,: .,: ' ".. ' '...'.TH~: RECEIPT · $160, ~
<br /> ., ,, ;, , ,~..'.'...':..-.~ ',',,~:,:.:.. ~ · ,~. ~
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<br /> P~YE~: ARENDT~ LAR~Y ~' ·-'-.' ...... · ..... RECEIPT NO~ 6~34~
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<br />FOLLOWING MUST BE COMPLETED.' "I~,.:'I~' THE'.:'RE~RONS~BZL'ZTY. OF'THE APPLICANT TO ASSURE THAT
<br />ALL NECESSARY INFORMATION HA~ BEEN 'PE~ED;',,. .' ..... :',
<br />. · ....,',',,,;.,,.'..,; '.',.::...'....: .::,~',,~.,,.',' .... ,.,,..'.: .'.
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<br /> Pt. AN REVIEW: BY.. D~T~- ~_~ ~..'. C~TX ,JURISDICTION~ BY ........ DATE ............
<br /> REMARKS: AU: FLD "'.
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<br />OFFICE COPY
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