Laserfiche WebLink
MARION COUNTY BUIL~DING INSPECTION <br />SENATOR BLDG. NO. 22,5 <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 performing work on a property I own or OCCUpy, <br /> ] ama registered builder OR( ) the authorized representative <br /> of 8 registered builder, <br /> The work will be performed by a registered builder, <br /> Other , , <br /> I have read and agree to the terms stated on the reverse side of <br /> this document, <br /> DATE: 07/25/88 TIME: 3:20:92p <br />:OWNER:HARRIS, DONNA <br /> <br />SITUS ADDRESS: <br /> <br /> 11675 JAMES WAY SE <br /> /~UNSVILLE OB 97325 <br /> <br />USE OF BUILDING: <br /> <br />TERRY SILBERNAGEL - REP <br />371-3013 <br /> <br />DATE: <br /> <br /> TAX LOT: <br /> <br /> CONSTRUCTION TYPE: <br /> <br /> CONTRACT CITY; <br />~RION COUNTY <br /> <br /> SUBDIVISION: <br /> <br /> SITE NUMBER: <br /> VALUAT ION: <br /> <br /> RANGE: <br /> 8S lW <br /> <br /> i&~G ~OT: NO <br /> <br />NO [ <br /> <br /> 2 <br /> <br />5001 <br /> <br />' ZONE: I MAP; ' <br /> ~ 48 <br /> <br />, <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PER~IT OR APPLICATION NO: 9009970 <br /> <br />CONTRACTOR, NO. <br />HARRIS, DONNA <br />TERRY SILBERNAGEL - REP <br />371-3013 <br />PHONE: <br /> <br />WATER ~UPPLY: PW <br />TEST HOLE$ READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE~ g00 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: 7-22-88 <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM <br />EXISTING SYSTBI'4 EVAL. RPT. <br /> <br /> QOANTITY AMOUNT <br /> 1 $100.00 <br /> '::'TOTAL ASSESSED FEES $100.00 <br /> PREVIOUS RECEIPTS $0.00 <br /> " THIS RECEIPT $100,00 <br /> : 8 LANC OUR $o.oo <br />PAYEE: SILBERNAGEL, TERRY ' RECEIPT NO: 10656 <br />RECEIVED BY: ¢1 ; TYPE: CK CHECK ~: 1034 <br /> <br />SEE ATTACHED DOCUMENT FOR RE~dlRE~ENTS OF'ON-SITESENAGE SYSTEM. <br />* THIS IS NOT A PERMIT. T~I3 :APPLICATION MUST GO lltROUG~-~ A REVIEN PROCES.S {~HERE THE <br />FOLLOWING ~IUST BE CCNPLETED. IT: IS ,THE RESPONSIBILITY OF THE APPLICANT TO ~RE THAT <br />ALL NECESSARY INFOEf4ATION HAS BE~ pROVIDED. <br /> <br />PLAN REVIEW: 8Y <br /> <br />REPtARKS: LOAN R~4172 <br /> <br />DATE <br /> <br />CITY JURISDICTION: BY ......... DATE <br /> <br /> <br />