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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />I have teaci an0 agree to the term*l stated on the reverse ~lde of <br /> <br /> 12~22 FRY.RD.' .NE.:. <br /> "AURORA' , · 0R.,'?.77~'~2" ', ' <br /> <br /> PHONE: 588-5147 8;00 <br /> 24 HOUR .CODE-A-PHONE: 588-7904 <br /> <br />The WOrK will I~e I~etlo~ne(t by a,~egis~red builc~e? ' <br /> <br /> RESIDENTIAL <br /> <br />· . ,. · · '~ ..... ~ ........... ~b¥~- - ' <br /> <br /> L SITE NUH~ER: 93-~393S <br /> PHONE: 678-2247: VALUATION: <br /> <br /> TYPEc ON~TE $~R~ ' , , I SATYR ~UPPLY~ P8 <br /> <br />.... 'P~HZT OR' RPPEICAT~ NOt'"' ~eS~A "~. SITE '~ALUAT~0N <br />~ ,, : ' .,,-. I' EX~STZNG TANK.. S~ZEc '. <br /> CONTRACTOR. NO .... :. EXISTING DRAIN FIELD LINES: 256 <br /> F~SHEE, NATHAN ' , SEPTIC TANK PUMPE~: 11/11/93 <br /> <br /> · '..: ..... '. · ' · <br />....PHONB: 678~ 7 .~ , <br /> <br /> ' ~ ...... ' ~'~ QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE ~ 1 <br /> <br /> · .. $168.88 <br /> <br /> ~Y~E; ' F~ SHER;..'..N, RECEIPT HOc.- 537&~ <br /> RECE[VE~ BY= ~H2 TYPE.' CK CHECK ~ <br /> SEE ATT~CHE~, p~CUNEHT <br /> · THIS IS " ~ REVI~ PRO.SS WHERE THE <br /> FOLLOW~N~ MUST 'BE .~ APPLICANT TO A~SU~[ THaT <br /> ALL NECESSART [NFO~MATI <br /> <br /> PLAN REVIEW: BY BY .............9ATE <br /> REMARKS: .... - <br /> <br />Fo~ # ~ ~-~. ~ OFFICE COPY' <br /> <br /> <br />