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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO- 225 <br />220 HtGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: S88-,5147 8:00 - 4:30 <br />· 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered brinier OR ) the authorized representative <br /> <br />The work will t~e peHormrd by a registered builder. <br />Othar <br />I have remd an~ ,~9¢80 to the terms stated on the reverse ~ide M <br /> <br />~I~iNATURE OF APPLICANT: <br /> DATE: <br /> <br />;)EHOT~ CHEEYL <br /> <br />.......... ~I]'MSVILLE . OR 97:325 <br /> <br />127e EWALD AVE SE <br /> <br />OCCUPANCY; <br /> RESIDENTIAL <br /> <br /> LOT'. '~'~[~ ~' ............. <br /> 51 <br /> <br />7.95 AC NO NO <br /> <br />TYPE= ON-SITE 8E#A§E WATER SUPPLY: <br /> TEST NOTES READY: <br />PERHIT OR APPLZCATI'DN ND~ 52157 SITE ~ALUATION NUHBER: 42814 <br /> <br />COHTR~CTOR~ HO- : <br />DEHUT. CHERYL ~' SEPTIC TANK PU~ED= <br />129~ EaALD AVE'SE ~:: ..,..,:~... PREVI~$ NO. BED~QOHS: <br /> <br /> [TEN :"':" ~UANT[TY <br />~TANBAR~ ON-SITE SYSTE~ <br /> <br /> PAYEE: <br /> RECEIVE~ BY; <br /> <br /> SEE ATTACHED DOCUNENT <br /> <br />CONSTRUCTION FAILS TO; <br />ZONIN~ OEBINANCES~ <br /> <br />AMOUNT <br /> $255.08 <br /> <br />$0.0~ <br /> <br /> RECEIPT NO: <br />TYPE'~ CHECK <br /> <br />I~UE DATE. IF <br /> COUNTY BUILDING AND <br /> <br />EO,u # UC ~.~ ~'V, ~/~o OFFICE COPY <br /> <br /> <br />