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 />~ am performing work on a property I own or occupy. <br />I am a registered builder OR the authorized representative SIGNATURE OF APPLICANT: <br />of a registered builder. ........................ <br />The work will be performed by a registered builder. <br />Other <br />I have read and agree to the terms stated on the reverse side of DATE: <br />this document, <br /> <br />VENICE PROPERTY COMPAqY, INC. 67~9-800 ~ RES'[i)ENT]'~L <br /> <br /> 2:La HILL ST -- ~-EE~E~Y~i~Yi <br /> ~ETROIT OR ~7742 . DETROIT <br /> <br /> ~ SW FLOWER/GUY HARPER~ PRES. ~ <br /> PORTLAND OR 97201 SITE NUMBER: <br /> PHONE: ~1~-395-8119 ~ VALUATION: <br /> <br /> ~ ~_._~ ..................20 .................. L-.~ ES~ ............ J <br />TYPE: QN-~ITE 8EWA6E WATER SUPPLY: 6W <br /> <br />PERMIT OR APPLICATION MO: 48593 <br /> <br />CONTRACTOR, NO. 36421 <br />KEVIN~S BACKNOE <br />PO BOX 465 <br />DETROIT, ~7342 <br />PHONE: 854-3797 <br /> <br />TEST HOLES READY: YES <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS ilO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br />SITE EVALUATION, FIRST LOT 1 $285.00 <br /> <br />TOTAL ASSESSED'FEES <br />PRE~IDUS RECEIPTS <br />TNI:S,.EECEI, pT., <br /> <br />PAYEE: INVOICE NO: <br /> <br />$2&5.00 <br /> $0.00 <br /> <br />$0.80 <br /> <br />RECEIVED BY: PB .................................... TYPE: CNECK ~: 0 <br /> <br />SEE ATTACHED DOCUMENT FOR REOUIREMENTS',OE.ON-SITE SEWAGE, SYSTEM, <br /> <br />NOTE: THIS DOES NOT GRANT'OR IMPLY' PERMISS,ION 'TO 'BtJ~[LD' ON THIS F'ARCEL. PLANNING AND <br />ONSTRUCTION PERMITS MUST BE OBTAINEI)BEFORE BU~hDING OR SEPTIC INSTALLATION BEGINo, <br /> <br />REMARKS: <br /> <br />BONAL..D E. <br /> <br />SE TN: STANDARD SYSTEM. <br />WOODLEY, NARION COUNTY BUILDINGOFFICIAL / BY ............................. ,~¢.~,,,. ..................... <br /> <br />FORM ~/MO 1~,~ S~M. 4/(,<~ OFFICE COPY <br /> <br /> <br />