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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG. NO. 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br /> PHONE: 688.5147 8;00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br />~IGNATURE OF AI:'PLICANT: ............
<br /> DATE: ............
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<br />oW,DATE.* D~'/20/9'2 .... T'ZMF..'t'"' '9'-:~3'."'46- ............. 'FAX ~,0i:: ....
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<br /> PETEREK~ .. R[C~A~;D ........................
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<br /> 15068 ;SEf~.~OND ST
<br />AURORA
<br />oF ~u~LmNC;~ ......................
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<br />CONTRACT CITY'. .! UGB; · ~ C~CCUPANT LOAD;
<br />
<br /> ~ .......... PA RC~t. '~t3 ....
<br /> p.o. eox 3~.~ I ~-[J'q:Y'/
<br /> , ~E: 6'18~589~ ~ ~IT~ NU~ER: 92-00523
<br />.................................. ~ ................................... ~ .......... ~AT~..:~ ....... : .................... ~ -. ·
<br />'LOT: [BLOCK: SECTION. ~WNSHIP: RANG~ : ZONe, , MAP,
<br />
<br />, ...................... ~ .............. '. ..... : _L ..... ~ .........
<br />[wiDTH: ~O~H: ............ ~'~[A; ..... ~"" UNITS:' ' .... 4~ IRR~G, LOT: ~ ~CORNER:
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<br />TYPE: r.)N-SITE SEWAGE
<br />PERMIT OR APPLICATIC~I iNO-. 38087
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<br />~'[E~ , Ri~ARD ,,; "::. :. ::";'.' ~,"~,'"'," ~;".
<br />P.O. BOX 3~9 ·
<br />~, OR ',
<br />
<br /> WATER E~JPPLY~' CW
<br /> TE~T HOLE:5 READY=
<br /> SiTE ~A~AT[~ N~ER:
<br />
<br />~i~TIN~, D~IN FIELD LIN~
<br />..:~O.~ ,T~..,~PEO~
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<br />PHONE: 678-5893 '. ,,: ''m ·
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<br /> iT~ , , ".' .:'?,:',',':,' · · ".,: ',, ,:,, ,....:-. :" ... .. ,:' ,, ,,, ' , QUANTITY A/vlOUN'F
<br />~5~l'E EVA~ATZ~. ~. AD~.:j,,EO~':~';...':?.'...,.;..,,?~'~,?].,..rh: ' ):,,,','"""' . I $~SO,OO
<br /> .'. :.' ,'! ,".,:~"' 'b'.::'-. 5 '" :"'.'.'.'.:~0~:;~:.'~'$ ~ 5o. oo
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<br /> , .......... .~. Y~,~ ~IPt ............. $0.oo
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<br /> ,, ..~ ..... ~. ~c~ ~ . $o oo
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<br />PAYEE~ ...... ~Z~,::;':,~ ~"'~'~;~:;~"';"'"X-~,, ' "":'.'""~'h '".':';"~' ..~, :~ iN~l~
<br />RF~EiVED ~Y~ CR ...... -~:~ ~,~,~ '~,~..~_,,.,,~,~-.--~::~.. -~ - ~K ~- 0
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<br /> ' "' ," ."?."]: ..'"';',",'"?,"r...'.' ",'~ , '
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<br />NOTE= ~iS, ~. ~' ~"~Y..~i~I~ TO .~I~ ~ ..~I~ P~. P~INO ~D
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<br />DONALD E~ hK~ODLEY, NTY BU,ZLG ICiAL
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<br />OFFICE COPY
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