Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am perform~g work on a property I own or occupy, <br />I am a registered builder OR ( ) the authorized representative <br />of 8 registered builder, <br />The work will be performed by a registered builder. <br />Other <br /> <br />I have read and agree to the terms Ststed on the reverse side Of <br />this document. <br /> <br />ow~;L~?'E: 08/2,0/90' T i~¥>~E.' 9:42:35 <br /> <br /> soNUENiNe~ iVAN <br />SITUS ADDRESS: <br /> <br /> 2.0357 HIGHWAY 99E <br /> AURORA <br /> <br />USE OF BUILDING: <br /> <br />TAX LOT: <br /> <br /> NE i CONTRACT CITY: UGB; <br /> <br />...................... ~R~ON ~N}'Y-; <br /> <br />SUBDIVISION: <br /> <br /> SAME <br /> <br /> PHONE; 678-2700 <br /> <br />LOT: : BLOCK: <br /> <br />WIDTN: DEPTH: <br /> <br /> SiTE NUMBER: 2821 <br /> :VALUAT.ION ~ <br />S~CTION; : ~OWNSHIP; ' RANGE: ZONE: <br /> <br /> AREA: 2',~' : UNITS: ~'S IRREd LeT; CORNER: EFU <br /> ~ 53 i ~ ~ES NO <br /> <br />CATEGORY: <br /> <br /> RESt DENT IAL <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />MAP: <br /> <br /> 5 <br /> <br />TYPE: ON-SITE SENAGE <br /> <br />PERNiT OR APPLICATION NO: <br /> <br />CON TRAc'roR, NO. <br />~,.,qHU F,~ ING, IVAN <br /> <br />PHONE: <br /> <br />28753 <br /> <br />~/AI'ER ~JPPLY: <br />T~'F HOLE~ READY: <br />SiTE EVALUATiON NU~ER: <br />~iSTiN6 'F~K SIZE: <br />~I~l'IN6 D~iN FIELD LiNE~: <br />~EPTiC 'F~K <br />PREV~S NO. <br /> <br />il'EM ~JAN'FII'Y AMOUNT <br />REPAIR - MAJOR 1 $80.00 <br /> <br /> :TOTAL:AE~ED FEES $80.00 <br /> pREViOUS'RECEiPTS $80.00 <br /> THiS RECEIPI' $0.00 <br /> <br />PAYEE; <br />RECEIVED <br /> <br />BALANCE 0UE $0.00 <br /> <br />RECEIPT <br /> O~BOK <br /> <br /> TYPE ~ O <br /> SEE ATTACHED DOCUMENT FOR RE(~JiRE~ENT8 OF ~ITE ~EW~E 8~'f~+ <br /> <br />~ THIS IS A VALID P~IT * THIS ~IT ~1~ 360 ~ ~ iT~ I~E ~TE+ IF <br />~ST~CTi~ PAi~ TO ~T ALL ~1~ ~ STATE ~ ~O ~R[~ ~N~ BUlgiNG ~D <br />Z~1~ ~IN~C~, THIS P~IT ~ALLB~E NULL ~D ~ID. <br /> <br />REJ~qARKS; REPAIR F~t3993 <br />DONAL0 E. Nf, YDDLEY, MARION G'OONTY BUiLDiNG OFFICIAL / BY .................................................................................. _~. <br /> <br /> OFFICE COPY <br />FORM # MC 15.56 REV. 4/90 <br /> <br /> <br />