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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO, 225 <br /> 220 HIGH STREET NE <br /> <br /> ' PHONE: 588-5147 8:00- 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> · ' ' <br />am ~er orm ng work on a roper~ own or ~cu~y. <br />t ~m a r~i~tered builder O~ ( ) the authorized ~presentatlve ~G~RE OF ApPellANT <br />of ~ registered builder, · · <br /> <br />The work wli{ be performed b a re ' ~uilder. <br /> <br />I here Ce~E~ ~tee io ~he ~t~ en t~e Ceve~e si~e of O~TE= ......................... <br /> <br />KIM ALLEH, <br />52SI HOWEEL PRARIE RD NE <br />PNONE) 873-1144 <br /> ~LOCK: <br /> <br />WIDTH; <br /> <br />97:~0i <br /> <br /> TOWNSHIP: <br /> <br />SiTE NUI,IBER~ 94-a2173 <br />VALUATION'- <br /> <br />I i , <br />[ ............... <br /> <br />TYPE: ON-SITE sF_SIi~E I WATER SUPPLY: PW <br /> I TEST HOLES READY: YES <br />PERHIT OR APPLICATION NO: ~B,.~8 I SITE EVALUATION NUMBER= <br /> ~ EXISTING TANK <br />CONTRACTOR9 NO. ~ EXISTING DRAIN FIELD LINES: <br />ALLEN. KEN -,'..","';'~,"'~";~:.~': <br />KIN ALLEN .~" ' ~REVIOU~ NO, ~DROOMS: <br />528~ HOWELL PRARIE ~D;:'flE <br />PHONE: ~7~=1144 '" <br /> <br /> I'fEH ';-' <br /> SiTE EVALUATION~ <br /> <br /> PAYE~: ALLEN~ KEN <br /> RECEYVED BY: c1 ...... <br /> <br />NOTE: THIS DOES NOT <br />ON$'FRllC'FIOH PERHIT: <br /> <br /> P[_~H REVIEW: ~Y <br /> <br />'; GUANTITY AMOUNT <br /> I ~265.00 <br /> <br />$265.00 <br /> $0.00 <br />$265.0~ <br /> <br />REMARKS: SE TH:READY :,,'"SEE A~O,.F~,EE ,~.'3"-"177 ;.:"',,'. .' <br /> <br /> RECEIPT NO: 57934 <br />TYPE= CK CHECK ~; 330J <br /> <br /> THIS PARCEL. PLANNI.,G <br /> INSTALLATION <br /> <br />~];~T'Y ,~IJ~!r'$1~ICTION: BY ........... DATE .............. <br /> <br />~:o~ ~ ~c ,~ .~v.,~ OFFICE COPY <br /> <br /> <br />