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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />230 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE; 588~5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-79O4 <br /> <br /> J.~5 GUYNORE; DR <br />I) ;Z T R 01T <br /> <br />MA[iKEY CREEK <br /> <br /> SITE NUMBER: <br /> YALUATION~. <br /> <br />TYPE: OH-S~[l'E SEWAGE <br /> <br />78~78~6 <br /> <br />gATER SUPPLY: OW <br />TEST HOLE~ READY: <br />SITE EVALUATION NUMBER: <br />EXZSTIN~ TANK SIZE: <br />EXISTING ~RAIN F~EL~ LINE~: <br />SEPTZO TANK PU~PE]): <br /> <br /> CUN?'RACTOR,. <br /> E'. U.B. AEK S. JiM <br /> 252? COF'FEY L.N .'. ........ <br /> SANTA RO~A~ CA 9.~495 ' ' <br /> PHONE= <br /> <br /> ITE~/~ . - '[ J ~..~. ', · , · ..:.,. . ,, . ~UANT~ 1Y AMOdNT <br /> ~ ' <br /> <br /> . <br /> ',".-...'.:.'..'. .'- ,,,,'TH~S RE~EI.P.T.'-.:'. <br /> ...... .........._ ..~, , ....... h., :,,:, '..'.. , · . . . <br /> ,.' ':' :... =.. ,:.',., , <br /> <br /> PAYEE~ EUBAIIKS~ J[fl :. ....... , ~.. '~':""':".:'.'",",,:h,,: ,,~,,:...".....~: ..... ~NVO~O: 3~49 <br /> <br />FOLI,.OH?~oM?ST B~ gOHI~LETEb.'.. IT'/,,~$',THE-.'RE~PONSl'BI~ITY'OF (HE APPLICANT TO A~8URE TFAT <br />'FTM /"' ~; ALT <br /> <br />OFFICE COPY <br /> <br /> <br />