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Permit - 1279533
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Permit - 1279533
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Entry Properties
Last modified
3/15/2011 3:24:01 PM
Creation date
9/3/2003 1:57:47 PM
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Template:
Permits
Permit Address
9784 MILL CREEK RD SE
Permit City
Aumsville
Permit Number
92-03253
Permit Type
Permit
Permit Doc Type
Permit Document
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MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG, NO, 225 <br /> <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 />of a registered builder, <br />The work will be per;ormed by a registered builder, <br /> <br />I have read and agree to the terms stated on the reverse side of DAT~: <br />this d~cument, <br /> <br /> DATE: 09/14/92 TIME: 9:11:22 <br /> KLEIN, L~REY ~ 56401000 ~ RESIDENTIAL <br /> <br /> 9804 ~ILL CREEK RD 8E <br /> AUHSVILLE, OR SiTE NUMBER: 92-0525~ <br /> PHONE: 74~-2405 VALUATION: <br /> <br />LOT: <br /> <br />WIDTH: <br /> <br />TYPE: OH-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION MO: <br /> <br />CONTRACTOR. NO~ <br />KLEIN, LARRY <br />9804 HILL CREEK RD SE <br />AUMSVILLE, OR <br />PHONE: 749~2405 <br /> <br />9042507 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTINO TANK SIZE: <br />EXISTING ORAIN FIELD LINES: <br />SEPTIC TANK PUMPED: WILL 8RING IN <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE ~ FLD. VISIT 1 $iSO.O0 <br /> <br /> TOTAL ASSESSED FEE8 $1SO.O0 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $150.00 <br /> <br /> 8~LRNCE DUE $0.00 <br /> <br /> PAYEE: KLEIn, LARRY : ::::~:: :i <br /> RECEIPT <br /> NO: <br /> 44576 <br /> RECEIVED BY. cl ...... ~_==~ TYPE: CK CHECK ~: 1061 <br /> <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ONrsITE SEWAGE SYSTEM~ <br />* THIS iS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORNATION HAS BEEN PROVIDED. <br /> <br />AUTH TO HOOK TO ~XISTING 8YSTEH , ., . t ~' ,, <br /> <br /> <br />
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