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 a registered builder OR ( ) the authorized representative SIGNATURE OF APPLICANT: <br />of a registered builder. <br />l'l~e work will be per¢ormed by a registered builder. <br />°,her_ <br />I [lave read and agree to the terms stated on the reverse side Of DATE: <br />this documenh <br /> <br /> DA-FE: 05/19/88 TI~4E: 2:04 ;28p <br /> <br />OWNE~: DAHL.E, ELDEN D- & SHARON <br /> <br /> 10908 S;~PSON ~OAD <br /> A.~SV [ LLE OR 9?325 <br /> <br />CATEGORY: RESiDENTiAL <br />OCCUPANCY: <br /> <br />5520 WiNC.'~JOR ISLAND RD <br />SALEM 9?303 <br />PHONE: 393-?734 <br /> <br />LOT: <br /> <br />SUBDIVISION: <br /> <br /> SITE NUMBER: 4439 <br /> VALUATION: <br /> <br /> BLOCK: 'SEOTI0kl , TOWNSH IF: : RANGE~ <br /> 20 8S IN EFU 49 <br /> <br />DEPTH: AREA: 48-0000 !UNITS: AC IRREG, LOT; YES <br /> <br />TYPE; ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO, <br />DAHLE, ELBEN D. & SHARON <br />6520 WINDSOR :gLAND RD NO <br />SALEM 9?303 <br />?*HONE: 393-??34 <br /> <br />9008523 <br /> <br />WATER SUPPLY: ~ <br />T~T HOLES READY: YES <br />SITE EVALUATION NUMBER: <br />E?(ISTZNG TANK SIZE: <br />EXISTING DRAIN F;ELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO_ BEDREE)MS: <br /> <br /> ITEM QUANT I TY A ~OUN 'r <br />SITE EVALUATION, FIRST LOT i $!75-00 <br /> TOTAL ASSESSED FEES $175-00 <br /> PREV~OUSRECEIFTS $0.00 <br /> THIS RECEIPT $i75.3o <br /> <br /> BALANCE DUE $9,00 <br />PAYEE= DAHLE, ELDE~ D & SH~RE~'q .4~.,~/~ RECEIPT NO.: 92?4 <br />RECE,VED BY. pb ,///~ ,YPE; CK CHECK ~- ~109 <br /> <br />SEE ATTACHED DOCUMENT FOR RECCJZREME'NTS OF ON-SITE S~AGE SYSTEM. <br /> <br />NOTE: THIS DOES NOT ~F~NT~OR IMPLY PERNtSSION TO BUILD O~: THIS PARCEL. PLANNING AND <br />CONSTRUCTION PER~IITI~' ~ BE CaTA~NED BEFJ;)RE BU~ILDING OR SEP~TIC INSTALLATION BEGINS. <br /> <br />REMARKS= SITE EVAL. R~814.1 <br /> <br />~c.u ,, MC ~-~,~ .~V e/87 OFFICE COPY <br /> <br /> <br />