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MARION COUNTy'IB'LALLDING INSPECTION <br />SENATOR BLDG, NO. 2:~5 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97,~01 <br /> <br /> PHONE:588-5147 8:00-4:30 <br />24 HOUR CODE-A-PHONE; 588-7904 <br /> <br />~Ii~NATUR~' OF ApPLICANT~ ........................... <br /> <br />DATE: ............ <br /> <br /> ~5 GUY~ORE DR -- ~, <br />DETROIT OR ~7342 DETTROZT !NO <br /> <br />PO I~OX 6~9 <br />DETROIT OR 973~2 ) S[TE NUN~ER: <br />PHDNE:: 85~,.-$132 ~ VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br />PERMIT OR APPLICATION NO: :5783& <br /> <br />CONTFtAC'~OR,~ NO,, <br />GIJHD~RSDN. DWAYNE & JULZE · .: ..... .. <br />F'D BOX 639 ' <br /> OR 97342 <br /> <br />WATEg SUPPLY: CW <br />TEST HOLES RE~DY: <br />g~TE EVALUATION NUMOER: <br />gXtS'rING TANK <br />EXISTING DRAIN FI£LD LIN~S: <br /> <br />PREVIOtJ~ NO. B~'D~O0~$: <br /> <br /> D F' 'R 0:1: 'r <br /> <br /> REF~IR -- M~JOR "" .:'~'.",,... ~ ~ . ' <br /> '~,-t-.:.'.'.,,,' 'TOTAL: ASSESS~ FEES <br /> ' .' 7' ,' ~ '.. .'. '.,:P~DU, B.R~CEIR~ $2~. <br /> ., ,, .~ .... · .... ,. ~:~ ~ ~c~ t ~ ~ .. <br /> .... · . ....-,-v .... - ......... ~ c~ q ~ ~t~'~ <br /> · '..,~',,'.',/5~?: ~,';:, ,, ...."' :.::'~t'~$~ :'~)~" :" · <br /> <br />COHSfRU[;'FION FAILS TD HE~T~'A'k~':.RBO~:~g~NT~ ,'OF' STAYE,'gg~$ .ANP MARION COdNTY BUI~.,DING <br />ZON]/NG ORDZNANCE$~ THIS P~'H~T'SHfiL,[, BECOME;; NULL ~lqD ,,VOID. , <br /> <br />OFFICE COPY <br /> <br /> <br />