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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH"STREET NE <br /> SALF~.~i 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 />i arna registered builder OR the authorized representative <br /> of a rec~istered builder'. <br />The work will be performed by a registered builder. <br /> <br />DATE: 05/05/88 TIME: <br />OWNERI <br /> SPARKS, B P.A I N <br />SITUS ADDRESS: <br /> <br />3:52:12p <br /> <br />TAX LOT CATEGORY <br /> <br />RESIDENTIAL <br /> <br /> 150 SANTIAM AVE <br />DETROIT <br /> <br />OR 97342 <br /> <br /> C~NTRACT CITY: UGB OCCUPANT LOAD <br />DETROIT NO <br /> <br />MAILING ADDRESS: <br /> <br />1220 MONMOUTH <br />INDPENDNECE. OREGON 97351 <br />PHONE: <br /> <br />LOT BLOCK; SECT ON TOWNSHIP. <br /> 6 9 1 <br /> 35 150 5250.00 <br /> <br />SggC VISION <br /> <br /> HAIv~40N B <br /> <br /> SITE NUMBER: 4354 <br /> VALUATION: <br /> <br />10 5E RS <br /> RREG. LOf CORNER <br />SF NO NO <br /> <br />105 <br /> <br />TYPE: ON-SITE SEt, VAGE <br /> <br />PE~4IT OR APPLICATION NO: 9008323 <br /> <br />CONTRACTOR, NO. <br />SPARKS. BRAIN <br />1220 MONNOUTH ~t39 <br />INDPENDNECE, OREGON 97351 <br />PHONE: <br /> <br />NATER SUPPLY: <br />TEST HOLE5 RFAOY: <br />SITE EVALUATION NUMBER: <br />E~ISTING TANK SIZE: 400 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: 6/19/86 <br />PREVIOUS NO. BEBROOHS: <br /> <br /> ITEM <br />AUTHORIZATION NOTICE - FLD. VISIT <br /> <br />PAYEE= SPARKS. BRAIN <br />RECEIVEO BY: CE <br /> <br /> QUANTITY AMOUNT <br /> 1 $105.00 <br /> <br />TOTAL ASSESSED FEES $105.00 <br />PREVIOUS RECEIPTS $0.00 <br />THIS RECEIPT $105.00 <br /> <br />BALANCE DUE $0.00 <br /> <br /> INVOICE NO: 8972 <br /> TYPE: IN: CHECK ~: 0 <br /> <br />SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SENAGE SYSTEM. <br /> <br />* THIS IS NOT A PEI~4IT. THIS APPLICATION I~UST THROUGH A REVIE~ PROCESS ~HERE THE <br />FOLLD~ING MUST BE C(~4PLETED. TT IS THE R~IBILITY OF THE APPLICANT TO AS~JRE THAT <br />ALL NECESSARY INFORMATION ~ BEEN PROVIDED+ <br /> <br /> ,EVIEW, CITY JURISDICTION:BY__ OATE ......... <br />REMARKS: AUTH <br /> <br />FORM, MC 1!1-56 REV 8/87 OFFIC¢COPY <br /> <br /> <br />