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MARION COUNTY BUILDING iNSPECTION
<br />SENATOR BLDG. NO, 225
<br />220 HIGH STREET NE
<br /> SALEM~ OREGON 97301
<br />
<br /> PHONE: 588-~;147 8:00 - 4:30
<br />24 HOUR CODE-A-PHONE: 588-7904
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<br />/ ........... ~ ~ ~"?-SA 74~5-'8~i ~ R~,;~.D~NT~AL.
<br />
<br />r AUH~VILLE OR 77~25 i¢tARION COUNTY ~ NO
<br />ku~-~K ................................................... ~ ........................... ~ ...................... ~ ...... ~ ~o, o~
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<br /> AIJ~ISV~I.LE ~ SITE NU~BE~: 9~$1692
<br /> PHONE~ 74<~- ~.583 ~ VALUATION:
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<br />TYPE: ON-~ITE SEWAGE
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<br />PER~IT O~ A?PLICATION NO:
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<br /> S~AYFON SEPTIC
<br />
<br />*~ ...... STAYTON ~
<br /> ~l,,I.O OR ~E .....
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<br />~ATER 8UPPL~: PW
<br /> E~T HOLES READY:
<br />8ITE £VALUAT~ON NUMBER: 81-~4
<br />EXISTING TANK SIZE:
<br />EXISTING ~RAIN F~ELQ LINES:
<br />SEF'I'I~ TANK PUMPED:
<br />?R~VIOUS'NO. BEDROOMS:
<br />
<br /> STAY1TIN~ ~7383
<br /> [:'HON~7: 769.-2~02
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<br /> ITEiN QUANTITY A.~OgNT
<br /> STANDA~D ON-BITE sYmPTOM .:.:'] .... : .... · -...-. ... .. ,,,:, ~ ',':,,
<br /> : i: TOTAL.:~ESSE~.
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<br /> '. · ~'. · .':..~H'X~;
<br /> ' .' '.,,,.',:. ;,: '.' · ". ". '%~ALA~CE.:~UE ' '
<br /> , ~:',,',r,';:; '.,% ? ';.' ~, ?' .',,~ ¢....~ , '..... . · · ...'
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<br /> ; .................... :~~::::::::::::::::::::::::: ..... :-; ............................
<br /> ..)EE A?'ACNEQ I)OC~;HENT FOR. R,.~UIR~EN:rs OP. ON-SITE SEWA6~
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<br />FOL]_OWtH~ ~tJ~l BE COHPI.ETE~,':'t~I:~',,I'~ ~THE~,: REORONOlBILITY OF THE APPLICANT TO A~SURE THAT
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<br />FoP~ ~ ~c ~,~ P~, ms, o OF FICE CO PY
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