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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />320 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:3(:) <br />24 HOUR CODE-A-PHONE: ~88-7904 <br /> <br />~IGNATUR~ OF APPLICANT: ................. <br /> <br /> DATE; ............... , .... <br /> <br /> PF!ONi{~ 749,-2~79 VALUATION: <br /> <br /> ...................................... ~ 8~ '~' .......................... <br /> <br /> ~ : 4.~4 ; AC lng NO <br />.................. ~,~,,,,.,.....~ L,_. i I .................................. ~ .......... ; ........................ <br /> <br /> TYPE: 0N-SITE SEWAGE WATER SUPPLY: PW <br /> <br />'TEST HOLES READY: YES <br />SITE EVALUATIGN NUMBER: <br />EXISTING ~' ' -' ' <br /> ,ANK 5~ZE. <br />EXISI'iN5 ~R~IN FIE.~ LINES: <br />~EPTI~ TANK PUHPED~ <br />PR~'VIDUS NO. BEDROOMS: <br /> <br /> ITeM ' .". QUANTI'Ty AMOUNT <br /> <br /> ..... : '- :.' · PREVIOUS. R~CEIFT5 <br /> ..... ' '.::'.'. ':'.' .: .::.::'-' ':'.'~'TH~'8" RECE'IPT' ""' <br /> .:.>.........:..:. "....".-.,-~L~NCE DUc ·. ; <br /> ~'Oh~: .,,~ CSU~ .~ :' .':......= <br /> <br /> ~uF.., GRANT . M~S THIS PARC[L. <br />O~,qSi'Rt. Jr:'l"~05~ P~RH?rS ~UST ',~ OBTAIN[9. 8/FORE, BUiLgI.NG. OR' S~PT~C INSTALLATION <br /> <br />~on~, ~,,,c ~ n~. ~o OFFICE COPY <br /> <br /> <br />