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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 />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />gATE: 01/0B/92 .TIME: 1.1:54:27.. <br /> FORE, NAN, THER~A <br /> <br />' T~X LOT: <br /> <br /> CONSTRUCTION <br /> <br />RE51DF..~T J <br /> <br /> 562 tlTH ~ST N '~ONTFIA~TCI~: .... i'0~B; '' 'I~'UP^NY gOAD! <br />AU~i~ViLLE O" 9',~_. ' FJARZ.Oi~NT~E" <br /> ~(Jlgbl'N~J ..................................................... ..... ' ' g, NO.' ~'F <br /> <br />PHCNE: 749-1503 S%TE, NUIV~ER:, 9~-00~83 <br /> VALUAT 1~: <br /> <br /> 271~ 380~ 102980. ~F ~ NO ~ NO <br />TYPE: ~'[TE S~E ~TER ~PPLY: ~ <br /> <br />PER~IT OR APPLiCATION NO: 903787~ <br /> <br />CON TRACTOr, NO~ <br />FOR '-~,IAN, TH ERE.~A <br /> <br />PHONE: 749-1503 <br /> <br />TEST HOLE~5 READY= <br />SITE EVALUATJ, ON NU~ER: <br />EXISTING TANM SIZE: <br />EX~i. STI.N~. DD, A.[N..FIELD L.[NE,~'~ <br /> <br /> 1TFJ~ ~JANT[TY <br /> ANNUAL EYAL. - ~"F_.J~P OR HOE~dp <br /> <br /> '. <br /> ' <br /> ',,. THIS .R~EI. PT <br /> <br /> PAYEE: F~, THER~ : ",' '. '.':'.. · :" RECEIPT NO: <br /> R~EIVED ~Y: CL <br /> <br /> SEE ATTA~D <br />· THI~ I~' NOT A ~[T. ,, THiS APP~T[~',',~T"~ TH~,, A'R~[~ P~ ~ THE <br />~IN~ ~ST BE ~EETED. [T.'i~,.,TH~, R~:IB1~iTY"OE ~E APPOinT TO ~RE THAT <br />ALL N~Y IN~T~' H~.,B~ '.~I~., ,. '' <br /> <br /> AJVlOUNT <br /> <br /> $60.00 <br /> $o.oo <br /> $~o.oo <br /> <br /> $o.oo <br /> <br />39850 <br /> <br />RE~,RKS: TOTAL OF ¢/13OTH RES <br /> <br />CITY JURISDICTI(~: 8Y DATE <br /> <br />OFFICE COPY <br /> <br /> <br />