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MARION COUNTY BUILDING iNSPECTION <br />SENATQ_R BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 ¢:00 - 4;30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am eerforming work on a property I own or occupy. <br />t am & reg(stered budder QR I the aethorized regre~ent&tNe <br />of a registerod builder, <br />The work will be performed by a registered builder. <br />Otho¢-- <br /> <br />owN¢~RrE: o5/~9/9~ 'riME~ <br /> <br /> OVERSON, RICHARD & SHIRLEY <br />SITUS ADDRESS: <br /> <br />56501-909 <br /> <br /> 119;$'/ CAUSEY LANB <br /> AUMSViLLE <br />USS OF BUILDIN~: <br /> <br />9?325 <br /> <br />CONTRACT CITY: JGE <br />· ,lA R.i r,,~t. - COU N '1; Y NO <br /> <br /> ~.AME <br /> PHONE: <br /> <br />LOT: <br /> <br />?f59~40'F9 ~,,ITE NuNIBER: 92-01809 <br /> VALUA'f' iON: <br /> eLOCK: SECTION: TOW'~SMih: RA~: NdN~: <br /> <br /> 3~ 85.: ]N AR <br /> <br />CATEGORY' <br /> <br />OCCUPANCY <br /> <br />OCCUPANT LOAD: <br /> <br />RESi OEN I ,hAl, <br /> <br />MAP: <br /> <br /> 48 <br /> <br />'TYPE: ON-SITE SENAGE <br /> <br />PERMII OR APPLiCA'T'iON ND: <br /> <br />C%)N'T'RAC'i'OR~,NO, <br />OVE~, RiCHARU & ~HiRLEY <br />~AME <br /> <br />PI-tONE: 769-4079 <br /> <br />39927 <br /> <br />WATER ~UPPLY: PW <br />TE~f' HOLES READY: <br />~i'I'E EVALUATION NUMBER: <br />FSXIs'riNG 'rANK SIZE: <br />EX1S]'iNS BRAIN FIELD L[NES: <br />~EP'FiC TANK PU~PED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> t 'rEM L~UAN'T't 'I'Y AMOUNT <br /> RE'PAl R -- MINOR <br /> <br /> TOTAL ~ES,~ED FEES $?0.OO <br /> <br /> 8A~NCE ~E $0,00 <br /> <br /> PAYEE: R~CEi PT NO: <br /> RECEIVED BY: CL ................................................................................................................ TYPE: CHECK ~: 0 <br /> <br /> SEE AT1ACHEO ~UMENT FOR RE~R~'fS OF ON~Si1'E SEWAGE <br /> <br />~ THIS iS A VALID P6~IT * THiS PE~IT ~PiR~ 360 ~Y8 F~ iTS l~E <br />~ST~CTt~ FALLS TO ~EET ALL REdiReCTS OF STATE ~ ~D ~RI~ ~N'f~ BUILDING <br />Z~ING ORDIN~C~, THiS PE~Zf ~ALL BEdE NULL ~D <br /> <br />REMARKS; SEPI'IO TANK REPAIR ~ ~ <br />DONALD E. WQOOLEY, MARION COUNTY BUILDING OFFiCiAL / 8Y .................................................................................. ~ <br /> <br /> OFFICE COPY <br />PORM # MC ~ 6-56 REV. 4~ <br /> <br /> <br />