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 ach performin9 work on a property I own or occupy. <br /> <br /> Other .... <br /> <br /> DATE: 08flq173 TtidE: 14;0&:09 <br /> JENSEN,~ ~ALLAS ~ RESIdENTiAL ~ <br /> <br />" ¢22~ 923; ~ ST~YTON R9 SE ....................................... ~ ........... <br />'. AUMSVI:LI..E OR 97S25 ~OT, t {.;~UN i Y ~ <br /> <br /> MAII.~NG ADDRESS; <br /> <br /> ,,~AHE i ........................................................................ <br /> j SiTE NUMBER: 93-~2850 <br /> F HONE,, 749-1,08~ VALUATION: <br /> <br />,~8~: ............... i ¢~6~'E; r~otf6~ ~6~ i'~; ......... ~ ~z .............. ~-Z6~ ~.~ ............... ~ .................. i <br />I ~ 2.81 ~C NO i NO ¢ <br /> <br />TYPE: ON-SITE SE~AI:;E <br /> <br />PERHIT OR APPLICATIOM <br /> <br />CON']~RACTOR. NO.. <br />JENSEN~ gAL _AS <br />~AME <br /> <br />PHONE: 749-1889 <br /> <br />WATER SUPPLY= PW <br />TEST HOLES READY: <br />SITE EVALUATION NUHBER: <br />EXISTING TANK SIZE: <br />EXISI'iN6 DRAIN PIEi,.D LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br />ANNUAL EVAL., - TEHP OR HDSHP i, tN 1 $90.00 <br /> <br />TO'fALASSESOED F~ES <br />P~EVIOU$ RECEIPTS <br />THIS.RECEIPT . <br /> <br />$0.00 <br /> <br />BALANCE-DUE $0.00 <br /> <br /> ...... ~ <br /> PAYEE: TRANSFERE MARION CO PLANNING RbCEIFT NO:., 08 <br /> i~ECEIVED BY: gL TYPE= IN CHECK <br /> <br /> SEE ATTACHED DOCUMENT FOR REQIJ'IR~HENT~ OF gN-StTE SEWAGE SYSTEM. <br /> * THiS ~ HOT A PERHIT. THI~ APPLiCATIQN ~U~T ~ THROUGH A REVIEW PROCESS WHERE <br />FOLLOWING HUST BE COHPLETE~. [T~ZS 'EHE ~SPONS[BIL~TY OF rilE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HA5 BEEN <br /> <br />DATE ............................... <br /> <br />FORM # MC 15-56 REV, 4/9~ OF FI CE COPY <br /> <br /> <br />