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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 8::00 - 4::30 <br />24 HOUR CODE-A-PHONE: 588-?904 <br /> <br />I am performing work on a property I own or occupy <br />lar'q areg~steredbJdderOR he au ho zed rep esentatve <br /> of a reg~sterod builder <br />The work will be performod by a registered builder <br />Other <br /> <br />DATE <br /> <br /> 03/25/91 lIME: 16:32;54 <br /> <br />snUSAneR~S~AfPiELD, S~EVEN <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />CATEOORY <br /> <br />OCCUPANC~ <br /> <br />RES;( DEN ~ IAL <br /> <br />7932 fr-RRANcE LANE <br /> <br />2289 SALEM DALLAS, HWY (~.,~,~i ~ E~ <br />SAL~5'Vl OR 97304 <br /> <br /> BLOCK SECTION <br /> <br /> CONTRACT CiTY <br /> <br />OR 9?925 <br /> ~NRi ON QOUNI Y <br /> ~ I~UBDI¥1SlON <br /> <br />UGB <br /> <br /> NO <br /> <br />SI IE NUf~J~R: ~4 <br />~AN~ALUAI ION: ZONE MAP <br /> <br />UNITS <br /> <br />8S Inneg LOT 2W CONNER <br /> <br />~r.~I . ......~0 ~O <br /> <br />AR 51 <br /> <br />IYPP._: ON-Si TE SEWAGE <br /> <br />PheNOl)ri OR APPLICA[I()N NO: 9030803 <br /> <br />CONh%,~.CFOR, NO. <br />HA[FiELD, SfEVEN <br />2269 SALEM DALLAS HWY <br />SALEM OR 97304 <br />PHONE: 362~6336 <br /> <br />WATgR SUPPLY: PW <br />rEST HOL~ READY: <br />SIiE EVALUATION NUIVlBER: <br />EXi~FING rANK SIZE: <br />EXI$1iNG DRAIN PI~LB LINES: <br />SEPTIC TANK PU~PEO: <br />PREVIOUS NO. B~OROOiV~: <br /> <br /> ItEM QUANTifY AIvFOUNf <br /> REPAIR IvlAJOR 1 $80.00 <br /> AUIHOR~ZAfION NOI'ICE ~ FLD. VISI[' 1 $105.00 <br /> ~OTAL ~D FEES $185.00 <br /> PR~WIOLI~ RECEIPFS $160.00 <br /> THIS RECEIPT $0.00 <br /> BALANCE E~E $25.00 <br /> RECEIPT NO: <br /> <br /> SEE AfrACHEO BOCUMENT <br /> <br />FOLL~IN6 ~ST BE ~PLETED. [T iS THE RB~SiBILiTY OF THE APPLZ~T 10 ~RE THAI' <br />ALL NEC~RY INFO~Ti~ H~ BE~ P~VIDEO+ <br /> <br />PLAN REVIEW: BY ............ DArE ...................... CiTY JURI~OiCFiON: BY <br />R~MARKS: MINOR REP~iR/AUTH FIELD Vigil CHG TO MAJOR REPAIR ~AL DUE <br /> <br />DATE <br /> <br />FORM # MC ff5-~6 REV 4/90 OFFICE COPY <br /> <br /> <br />