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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 lAM, - 8:00 A.M. <br /> <br />I I am performing work on a property I own or occupy. <br /> <br />DATE: 04/26/90 <br /> DAHL, ~ERT <br /> <br />TIME: 9:01:37 <br /> <br />S~GNATU R E OF APPLICANT: <br /> <br /> DATE: <br /> <br /> 5932 VILLAGE VIEW COURT <br />AUMSVILLE OR 97325 <br /> <br />USE OF BUILDING: <br /> <br />SE <br /> <br />CONTRACT CITY: UGBI <br />MAR[ON COUNTY NO <br /> <br />MAILING ADDRESS: <br /> <br />PO BOX 1457 <br />CEDAR CITY, UTAH 94?20 <br />PHONE: 801-586-8081 <br /> <br />SUBDIVISION: <br /> <br />VILLAGE VIEW <br /> <br />CATEGORY: <br /> RESI DENTIA~ <br /> <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br /> NQ OF BEDROOMS <br /> <br /> 2 <br /> <br />SITE NUMBER: 9995 <br />VALUATION: <br /> <br />AC IRREG. LOT: NoCORNBR: NO <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO, <br />DAHL, ROBERT <br />FO BOX 1457 <br />CEDAR CITY, UTAH 94?20 <br />PHONE: 801'-586--8081 <br /> <br />9023512 <br /> <br />WATER SUPPLY: PN <br />TEST HOLE'X3 READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1000 <br />EXISTING BRAIN FIELB LINES: <br />SEPTIC TANK PUNPEB:= <br />PREVIOUS NO. 8EDROO~: OWN <br /> <br />45O <br /> <br /> ITEM ; ' QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE - FLD. ::: i:'] :: 1 $105-00 <br /> <br /> L ASSE,.SS'ED FEES $105, O0 <br /> : ; iPREVIOUS RECEIPTS $0,00 <br /> ,~, THIS RECEi PT $105, O0 <br /> : BAL. CE WE *0.00 <br /> <br /> PAYEE: DAHL, ROBERT " RECEIPT NO- 24932 <br /> RECEIVED BY: ~8 ....... i.___:~&.z'___ z .......... ._;_: ::: .:'~,~E,:.:CK CHECK ~: 0 <br /> SEE ATTACHED DOCUMENT FO~ REQUTREJ~4EN'{S, <br />* THIS IS NOT A P~[T. .:TH i A REVfEW PROCES,S ~/¢IERE THE <br />FOLLO~[N~ I~dST BE APPL[CANT TO ASSURE THAT <br />ALL NECEE>SARY [NFORI~IATTON <br /> <br />CITY JURISDICTION: BY DATE <br /> <br />PLAN REVIEW: BY ...................................... :DATE ............................................... <br /> <br />REMARKS: AUTH FIELD CHECK R~3300 <br /> <br /> <br />