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 />m ~m a registered builder OR ( ) the authorized representative SIGNATUR~ <br />of ~ registered builder, <br />The work will be performed by a registered builder. <br /> <br />this document. <br /> 9ATE: ~8/~9/9~ T~HE: <br /> <br /> 79S~ STONI~ F'IELD CT SE, <br /> AUMSVILL. E OR 97;25 <br /> <br /> S~HE <br /> <br /> PHONE= ~45-&222 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PENNI? OR APPLICATION <br /> <br />CONTRACTOR. NO. <br />KAIL_EY, ,,JOHN H. <br />SAME: <br /> <br />PNONE: 945-6222 <br /> <br />9048972 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES REABY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: 1000 <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOOS NO. BEDROOMS: ~ <br /> <br />225 <br /> <br /> ITEM QUANTITY AMOUN'I <br /> EXISTING SYSTEM EVAL. RF'7~.'' 1 $160.00 <br /> <br /> TOTAL ASSESSED FEES $160100 <br /> " I ' : 'EIPTS <br /> <br /> BAI."ANCE DUE $0,8e <br /> PAYBE: KAIL. EY, J~l~ M~ RE6EIP~ N~: , 51~05 <br /> <br /> SEE ATTACHED DOCUMENT FOR REQUI~EMENT9..OE ON-SITE SEWAGE GYS'Y'EM. <br /> <br /> * THIS IS NOT A PERMIT. THIS APPLICATION MOST ~ THROUGH A REVIEW.PROCESS ~HERE THE <br />FOLLOWIN(i MUST BE COMPLETED. IT IS TNE RE~PON~IBILII'Y OF THE APPLICANT TO ASSURE THAT <br />ALL NEO~SSAI~Y INFORMATIBI HAS BEEN PROVIDED~ <br /> <br />REMAf~KS: SS:ESE WILL BRING IN ASSOF( .~IAP AND F'UMFIEI~ FORM <br /> <br />FOR~ # I~C 1 ~-~6 F{EV, 4/~ OFFICE COPY <br /> <br /> <br />