Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />I am a registered builder OR [ the authori[ed representative <br />of a registered builder, <br /> <br />Other_ <br /> <br />this document, <br /> <br />FILE <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> APPLICANT'C ~ , . . ..~ ~.~ <br /> SIGNATURE OF __~-__~ ~,~-~ ............. <br /> <br />D?k T ., ,_"i:y ,1,5'7646.,,,r?~00 IRESIDEi4TiAL <br />ALli"~![WIi...LE' OR r?7325 I'IARIOI~ COUNTY ~'NO ~ <br />MAILING ADDRESS: <br /> <br />L~[ 1 BLOCK'. ~$ECTION'. TTOWNSNIP'. F RANGE: ~ ZONE'. [ MAP: <br /> <br />TYPE: ON-SITE SELVAGE WATER SUPPLY.* PW <br /> TEST HOLES READY: <br />PEt~MIT OR APPLTCATION NO: ~52157 SITE EVALUATION NUMBI:.'R.' 42014 <br /> EXISTZNI; TANK SIZE: <br />CONTRACI[OF(., l,iO. EXISTING DRAIN EIEI.,i) LINES." <br /> E <br /> [.HEr~YL <br /> SEt:TlC ][A~,E: f' UN." E)). <br />D'"HUTt:L290 EWALI) A//E SIi?. PREVIOJS qO~ BEDRO MS: <br />SALEM <) 7:'~02 ~ <br />PHONE: 5S5-4861 '. <br /> <br /> FA?:K,. I)EHUT, CHERYL <br /> RE[,,[~IVED BY: DM2 <br /> SE.P, AT'I'ACHEI) IOOCUi~EI,IT FO <br /> ~ THIS I$ NOT A PERHI- <br />FOLLOWII,IG MUST gE <br />ALL NECESSARY t:NFORMATIQN <br /> <br /> $0.00 <br /> <br /> RECEZ F'l' I,I0.~ 5~6].1 <br /> TYPE: CK ,5HECX :$: ~)50 <br /> <br />~YS'FEH. <br /> REVIEW,PROCESS ~HERE THE <br /> 'NE' APPLI[,AN'[ TO ASSUi:~E THAT <br /> <br />F'L, AN REVTi~,/W,I :( Y .......,,,...:.. bAFE,::: ~:~; :2:: jUI:~ISI~iiCT][I'.)I,I. })¥', ......................... DA'i"E <br /> <br />OFFICE COPY <br /> <br /> <br />