Laserfiche WebLink
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 />I am performing work on 8 property I own or OCCUpy. <br />I am ~ registered builder OR the authorized representative <br /> of a registered builder. <br />The work will be performed by 8 registered builder. <br />Other <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />OWNER: DAtp.. 85/24/9;5 TIME.' <br /> <br /> BA~IE,r;~, DAVID & JANET <br />$1TMS ADDRESS: <br /> <br />CONSTRUCrlON TYPE: <br /> <br /> 864,~ SHAW SQUAF.'E RD SE CONTRACT CITY: LJGB: <br /> <br /> AUMSVIL, LE OR 973,~,~ MARION gOWN'FY NO <br /> <br />MAILING ADDRESS; ~UBGIOSION; <br /> <br /> PHONE= 588--8:1.55 <br /> <br />LOT: BLOCK: SECTION; TOWNSHIP: <br /> <br />SITE NUHBER: 93-8178§ <br />VALUATION: <br /> <br /> RANGE: ZoNEI <br /> <br />W~DTH: <br /> <br />t52 <br /> <br />: ,R~. LOT, <br /> <br />CATEGORY; <br /> <br /> RI_< S ]: DEi'IT :I: AL, <br />OCCUPANCY: <br /> <br />OCCUPANT LOADZ <br /> <br /> NO OF BEDROOMS: <br /> <br />MAP'. <br /> <br />TYPE: ON-SiTE SEWAGE <br /> <br />PERMIT DR APPLICATION <br /> <br />f~%)I,ITRACTOR~ NO. 041.:'~4 <br />Adolph H Schar"~"f~ <br />:L5f,} Cordm'l Roi NE <br />Salem 97:~8I--0008 <br /> <br />4714~ <br /> <br />WATER SUPPLY: F'W <br />TEST HOLES READY: <br />SiTE EVALUATION I,IUMBER:: <br />EXIST:[NI; TANK SIZE: <br />EXISTING DRAIN FIELD L:[FIE.S: <br />SEP'f']:C TAI,tK PUMPED: <br />PRE¥ISUS NO. BEDROOJ"iS: <br /> <br />580 <br /> <br />ITI:'H QUAN'f;[TY AY, OLtI,IT <br />REPAIR ,-, HI:NOR :[ ~i~.~,,"'" "08' <br /> <br /> TOTAL ASSESSED FEES $85.80 <br /> PREVI00S RECEIPTS $85,88 <br /> THIS RECEIPT ~1;8,, 80 <br /> <br /> BALANCE DUE $8,.8~ <br /> <br /> PAYEE:: RECIE I F'T I,t0: <br /> <br /> SEE ATTACHED DOCUOENT FOR REQUIREMENTS OE ON-SITE SEWAGE SYS'I'E~. <br /> <br /> ~ THIS IS A VALID PERMIT · THIS PER~IT EXPIRES ~68 DAY~ FRO~ iTS ISSUE DATE. ~F <br />CONSTRUCTION FAILS TO HEET ALL REQUIREMENTS OF STATE LAWS AND MARION CSUNTY BUILDING AND <br />ZONIN[; ORD'.[NANCES, THIS PERMIT SHALL BECOHE NULL AND VOID. <br /> <br />t~EMARKS: REP:H!N <br /> <br />,!)ONAL, D E. WOOI)L. EY,¢ HAR]:£)N C(U,TY BUi{I,,.DINI; f]F:'F]:CYA,,, / BY <br /> <br />FORM # MC ~ d Uf¢ REV, 4/90 <br /> <br />OFFI¢:E COPY <br /> <br /> <br />