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( <br /> <br />MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />PHONE: 588-5147 8:00- 4:30 <br /> <br />BORK~ ALA~ & PATR~CIA i J ~ESIDEN~(IAL <br /> AURORA , ,OR ~7~92 , ~, MARION COUNTY~ NO ' ' ~ <br /> <br /> PHONE: 678-2174 VALUATION: <br /> J ~ ~ , m <br /> <br />TYPE~ ON~ITE <br /> <br />PERMIT OR APPLICATION <br /> <br />CONTRACTOR, <br />BORK~ ALAN & PATRICtA <br /> <br />PHONE: ~78-~174 <br /> <br /> WATER ~UPPLY: PW <br /> TEST HOLE~.READY= <br />98497&9 ~ITE EVALUATION NUMBER: <br /> I EXISTIN~ TANK SIZe: 10~0 <br /> I EXISTING ~AIN F~EL~ L~NES: <br /> | SEPTIC TANK PUMPED: , <br /> ....... ~' PREVIOUS NO, ·BEDROOMS, 2 <br /> <br />375 <br /> <br /> ITEM : '. QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE ~ NO VISIT : : 1 $~5.00 <br /> ........ :,.' YOTA[.ASSESS[D'F~ES $?5.00 <br /> ,' ~.. .:':'..','::',', '.' .'"PREVIO,U~:~ECEIPTS $0,~0 <br /> '".-"'" '""' '. '" THIS'RECEIPT.:.' S95~00 <br /> <br /> SEE ATTAONE~ ~OCUMENT F~,~R,~Q~REMEN~,'Q~ ~N-SITE"SE~GE"SYSTEM. <br /> <br />FOLLOWING MUST ~E COM~LETE~.'..~T ['S',TH~ ;~ESPO'~S,[~'[E'ZTY OF THE APPLICANT TO ASSURE THAT <br />~LL NECESSARY ~NFORMAT[eH'N~S";BEEN PROV~ED.." ~'" , .... <br /> <br />PLAN REVIEW. BY .... DATE ........· ......... , ............. CITY,.JUR"~SDICTION: BY._ DATE ............. ~ <br />REHARK~: AU:NOFLD ' '.. : ......... ' ...... <br /> <br />OFFICE COPY <br /> <br /> <br />