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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO. ~25
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br /> PHONE-' 588-5147 8;00 - 4;30
<br />24 HOUR CODE-A-PHONE: $88-7904
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<br /> of a register'ed builder, ,
<br />The work will be peHorme'~ by a reg,stered builder.
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<br />I I~ave Cead and agree to the te,'mt,~ 8tared on the reverse side of
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<br />P~H:~T O~ APPL. ZCATI[ON N~; 57~64
<br />CONTI~CTOR~ NO.
<br />COYLE,~ H
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<br />PHONE: 698-7954
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<br /> I~TER SUPPLY; P~.
<br /> TEST HOLES REAgY.
<br /> S~TE EVAL~AT[0N NU~BER~
<br /> EXISTING TANK SIZE. ,
<br /> EXISTING BRAIN FIE~D LINES=
<br /> SEPTIC TAHK PUHPED.
<br />I'PREVIOUS,N0..:,BEDR00HS:
<br />
<br /> t!TEH " QUANTITY AMOUNT
<br /> AUTHORIZATION NOTICE -,FLD'.:'.',"V~S,iT ', : :'."':, ,,:,' '....': · ',: 1
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<br /> P~YEE: ....... '""' ~' -/ .... ' ..... .-. .....
<br /> DH ...... ~._=_~,~=~_~ ..... TYPE: CHECK ~:
<br /> SEE ATTACHED ~UCUHEHT F~":RE~NTs: O~"~S[T~.,SE~GE' SYSTEH.
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<br />ZONING 0ROINAHCES~ THIS PERHIT, SH~LL'
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<br />REMARKS: SS: AUTH, ...,. ~
<br />DONALD E. WOODLEY, HARION COUNTY 'BUILDIHG OFFICIAL / BY ] ..........................
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<br />OFFtCECOPY
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