Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO, 225 <br />220 HIGR 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 a re~~stered builder OR I I the aothorized representabve SIGNATURE OF APPLICA <br />Of a registered builder <br />The work will bo borformed by a registered builder <br />Other_ <br />I hi~e read and agree to fhe terms stated on the reverse sldo of (}ATE <br /> <br />DAT~': 09/15/87 TINE: 10:04:31,~ <br />OWNER <br /> <br /> DETROIT RANGER STATION <br /> <br /> '~-~¢e"!~!~'~'L'K N SANTI,N~I HNY <br /> DET~I T OR 97342 <br /> <br /> TAX LOT CATEGORY <br /> C(~qMER ICAL <br /> <br />MARION COUNTY NO <br /> <br />NO 0F 9£D~00MS <br /> <br />MAILING At~0RbSS ~-- SUBDIVISION 8 <br /> <br />DETROIT RANGER DISTRICT <br />HC 60 80X 320 MILL CITY <br />PHONE~ 854-2366 <br /> <br />9?360 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br /> <br />WIDTH DEPTll AREA UNITS <br />100.000 <br /> <br /> SITE NUMBER: 2518 <br /> VALUATION; <br /> RANGE ZONE MAP <br /> <br />10 5N TC 104 <br /> IHHEG LOT CORNER <br />AC NO NO <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERNIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 15477 <br />VALLEY PACIFIC <br />12312 SILVERTON RD <br />SILVERTON, OREGON 97381 <br />PHONE: 873-2701 <br /> <br />900434? <br /> <br /> I TFJ',I <br />STD ONSITE SYS < 1000 GAL <br />C & R - EACH ADDL. 500 GAL DSF <br /> <br />PAYEE: VALLEY PACIFIC <br /> <br />NATERSUPPLY: P~4 <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 86-911 <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES; <br />SEPTIC TANK PUMPED: <br />PREVI0OS NO. BEDROONS: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br />1 $125.00 <br />1 $10.00 <br /> <br /> $135.00 <br /> $o.oo <br /> $135+00 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIPT NO: 4911 <br /> <br />RECEIVED BY: cl ......... TYPE: CK CHECK ~r: 18000 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIRENENTS OF ON-SITE SEWAGE SYSTEN. <br /> <br />ALL N~ IN~TI~ ~ B~ ~i~_ <br /> <br />PLAN REVIEW: 8Y <br /> <br />RE~.RKS= ......... <br /> <br />DATE <br /> <br />CITY JURISDICTION: BY <br /> <br />DATE <br /> <br />~l::l'~ r' MO I" ::'4' ~E-v ~"~" OFFICE COPY <br /> <br /> <br />