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 <br /> CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />I am performk~9 work ~n ~ property I own or OCrL~py, <br />] am a registered builder OR ( ) the authorized representative SIGNATURE CE APPLiCANT~ <br />of a registered buitder, <br />The work will be performed by a registered builder. <br />Other <br />I nave re2d and agree to the terms stated on the reverse side of DATE'· <br /> <br />, o ~J"~E: 12/22/87 TIME~ 1:27.:.27p ..... i T/~ LOT; : ~A+~GOR¥: <br /> ~R'NN, MARION ~ <br /> , G842?~00o R <br /> <br /> 11054 MILL CREEK RD j CONTRACT QITY: i UGh; ~OO6¢PANT bOAO; <br /> AU~VI LLE OR ~ ' ~ <br /> ~R~.,~N~, ,J Ne <br /> <br />SAr4E <br /> <br />PHONE <br /> <br /> [ SU BD~VISION: <br /> <br /> i SITE Nur4~ER: 3366 <br /> ' ,VA~.T!~ <br /> <br /> 32 ~ 8S ! lW ~ EFU 48 <br />AREA: ' UNITS: , IRREG, LOT; i CORNER: <br /> <br />2 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PER~4IT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO~ <br />WYNN~ MARION <br /> <br />9006023 <br /> <br />NATER ¢¢JPPLY: PW <br />TEST HOLES READY; <br />SITE EVALUATION NUffSER: <br />EXISTING TANK SZZE: 1000 <br />EXISTING DRAIN FIELD LINES~ <br />SEPTIC TANK PUMPED: 3-20-86 <br />PREVIOUS NO. BED~; 2 <br /> <br /> ITEM QUANTITY AMOUNT <br />,NJTHORIZATION :NOTICE - FLD. VISIT ~, 1 $65.00 <br /> <br /> pRE~ t:OUS ~ REOE I::P,TS $ O. 00 <br /> , : ,,"¢rf;;~Si' REDEIPT $65,00 <br /> ;, ,8A~CE,,BUE _ ,., ,;:, $0. O0 <br /> : ;;;::~, , ': <br />PAYEE: HARRIS. ALLEN - LESSEE ',' RECEIPT NO*- 6604 <br />RECEIVED BY: CL ~PE:,':CK,;OHECK ~t.. 4??' <br /> <br />SEE ATTACHED OOCUNENT FOR <br /> <br />FOL~_.~Z~ NOT A ~4IT. THIS APm.~IC~"r,:ION m,~r,,eO:;TH~ A R~VZEI~ PROCESS ~F_.R~ THE <br /> <br />PLAN REVIEW: BY _ DATE i ]CITY JURISDICTION: 8Y ........ DATE <br /> <br />RENARKS: AUTH R~8545 ': <br /> <br />~O*M, MC ~,~e .tv. ~/./ OFFICE COPY <br /> <br /> <br />