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MARION COUNTY BUILDING iNSPECT[ON <br />SENATOR BLDG. NO. 825 <br />~20 HIGH STREET NE <br /> SALEM, OREGON 97501 <br /> <br /> PHONE: ~$-5147 $:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 5~-7904 <br /> <br />DATE', ...................................... <br /> <br /> --,v._ ) ~ % -~ ...... [ RE:~IDEN'[:AL. <br /> '~65 r, T';","''~,: AV~ , CO~AC~ mw u~: occu~A~ LOAD: <br /> <br /> z, ~ .... J?2.?~flB_I ~ .............................................. <br /> V'~..i~,~ ~:; 2~5,,,,64~B ~ VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE WATER ~UPPLY: CW <br /> <br />CONTRACTOR.. <br /> - ~.. <br /> <br />,~.2T HOLES R,F. ADY: <br />SITE ~VALUATION <br />~X'tSTiNF, JASIK SIZE~ <br /> <br />SEPI[',[C TANK F'UMRED: <br /> <br /> i ]'~N QUANT I TY ASOUNT <br /> <br /> ., REV ...... : kECEIP~,:~ <br /> ...... ,,.'7 ~%,.B RECEIPT <br /> ou: <br /> <br /> PAYEE: INVOICE <br /> RECEiV~ZD ~',Y;'. PI* ................................. g ........................ :. TYPE~ CHi=gK ~: <br /> <br /> ~EE ATTACHED ~OCUMENT FGR ~E~U~.R~M~TS'O~ ON-SIT~ s~wAG~ <br /> * TH~ IS ~ VALID P~RHIT · TH~S.'PER~IT EXPiRES'~&~ DAYS FROM ITS ISSUE DATE, IF <br />COb}S~RUCTTO;,; FAZLS TO H~'T ALL' REBUI~E~ENT~ OF STATE LAW~],,~N~ HAR~Of, I COON'FY ~.U~i,.)]:TR; <br /> <br />.... bm.. ................. ,...\,,.,S..D ~.,:.~E F~.,Ap~ <br /> <br />D,:~!,~;:1.?,, E,, L.',OODLL'-Y, MA!.'(.i!di,[ COUNTY r~Uli. D:,:i:S 0F'FiZ:[AL / BY , <br /> <br />~oaM ~ Mc ~.~ ~EV. 4t.o OFFICE COPY <br /> <br /> <br />