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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:: 588-7904 <br /> <br />Otheh <br /> <br /> DAr'E: 01/03/91 I'IM~: 12:12:07 <br /> <br /> DAVi~, ,JOHN <br />SRUS ADDRESS <br /> <br />CATEGORY <br /> <br />OCCUPANC~ <br /> <br />RESI DEN I iAL <br /> <br /> 12054 WESf' SfAYION RD <br />AUM~ViLLE OR <br /> <br />USE OF BLJILDING <br /> <br />9. 325 <br /> <br />CONTRACT C~TY UGB <br />MARi ON COUN l Y NO <br /> <br />OCCUPANT LOAD <br /> <br />SAME <br />PRIMARY DWELLINr4 Al 11579 MCCLELLAN <br />PHONE: ?89-?449 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br />13 <br /> <br /> 2. <br /> <br /> SIIE NUMBER.+ 12033 <br /> VALUAY ION: <br /> RANGE ZONE <br /> <br />9~ 2W EFU <br /> IRREG LOT CORNER <br />AC NO NO <br /> <br />MAp <br /> <br />62 <br /> <br />[YPE: ON-Sif'E S~-WAGE <br /> <br />PERMiI OR APPLICAflON NO: 90:89602 <br /> <br />CON r P. AC ~ OR, NO. <br />L)AV'I ~, JOHN <br /> <br />PRit',,1ARY I%NELLING Ai <br />PHONE: ?69-7449 <br /> <br />1579 MCCLE <br /> <br />WAlER SUPPLY: PW <br />'IESf' HGLE~ READY: <br />SIFE EVALUATION NUfCfSER: <br />EXiSlING lANK SIZE: <br />E,;XISIING DRAIN FIELD LINES: <br />~EPliC ~ANK PUMPED: WiLL BRING IN <br />PREVIOUS NO. BEDR~: <br /> <br /> I'I~M QUANIi'IY AlviOUNT <br />AUIHORIZAfION NOIICE - PLO. VlSlf 1 $105.00 <br /> ~'~ fOFAL ,nZS,~E~ED FEES $105.00 <br />  PREVIOUS RECEiPI$ $O.OO <br /> ~Hi~ RECE~P'I $q05.00 <br /> BALANCE BU~ $O+Od <br /> <br /> PA~Eb: DAViLY~ON, JOHN ~ REC~iP] NO: 312~9 <br /> RECEIVED BY: ~ .~_.~_ IYPE: CK CHECK ~: 3108 <br /> <br /> SEE ArFAC~ED LX3CUMENf FOR REQUIRF_.f4ENFS OF ON-SIrE <br /> <br />* THiS iS NOT A PE~iT. THIS APPLICATION MUST GO THROU~ A REVIE~ PROCESS ~HERE THE <br />FOLLO~NING I~UST BE ~PLETED. iT I~ THE R~$iBiLiTY OF THE APPLI~T TO ~RE THAT <br />ALL N~E~RY iNFO~Ti~ H~ <br /> <br />PLAN REVieW: BY .... ~. <br />REMARKS: AUIH R~3108 <br /> <br />ClfY JURiSDiCf'ION: ~Y DAlE <br /> <br />FORM # MC 15,56 REV 4/90 OFFICE COPY <br /> <br /> <br />