|
MARION COUNTY BUILDING INSPECTION
<br />SENATOR BLDG, NO, 2c'5
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE: 588-5147 8:00 - 4:$0
<br />24 HOUR CODE-A-PHONE: 588-7904
<br />
<br />ct a registered bu{Ider.
<br />The work will be perCormed by a registered builder,
<br />Other
<br />
<br />tl~is document,
<br />DATE: :1. 0/29/9;~i 'l'I i~E: 9:t5:25
<br />
<br />'~lfU'~ 'A~6~gg: CON,~TRtJOTION TYPE: OCCUPANCY:
<br /> 85:L2 HOI...M~UIST RD SE ~
<br />
<br /> ~.L~ NATIONAL CT SE
<br /> PHDNE: g64-5458 VALUATION:
<br />
<br /> [ ,~1 8s 1w AR 48
<br />
<br /> ± ~ } J L_,,,
<br />TYPE: OH-SITE SEWAGE WATER SUPPLY,". PW
<br />
<br />PERMIT ~R APPLICATIOH HO: 9~510~5
<br />
<br />CONTRACTOR,,
<br />Ken
<br />PO Box 21888
<br />Salem, 97J07-'000~
<br />FHONE:
<br />
<br />TEST HOLES READY:
<br />SITE EVALUATION ;,lUMBER: 13309
<br />EXISTIN(; TANK SIZE:
<br />EXISTING DRAIN FIE'LD LINES:
<br />SEPTIC TANK PUMPED:
<br />FiREVIOUS: NO~ BEDROOMS:
<br />
<br /> ITEM QUANTITY AHO[JNT
<br /> PRESSURE DI!~'f'RIBUTtON , 1 $360.00
<br />
<br /> :TO~AL ASSESSED FEES $.~60.00
<br /> P, EE~IOUS RECEIPTS $0,, 00
<br /> :: THTE:..RESEIPT $~60,00
<br />
<br /> $0.00
<br /> PAYEE: JOHNSON.~ flILLY,:E-:: :: ::: : ::::::::::::::::::::::::: :: : ~: :.,]:::,: RE.£,E,[FI' I'.10:
<br /> REOEIYED :BY: PM TYPE," 6K CHECK ~:
<br />
<br /> ,RE ]]ACNED DOCUMEHT:F0k RE[,tLJtREHENT~yOF ON-SITE,SEWAGE ,~YSIEM.
<br /> ...................... --,,:~..,..-....r.-:-.,.=,:-,-~,- i; :,.L-~.;;.L,,-,-,,....~.-~-....._.
<br /> ~ THIS TS HOT A PERHIT. RE¥IEW PROCESS WHERE THE
<br />FOLLOW?~ ~[ ST 3; COHP.ETED~ ET :TY OF TI.tS APPLICA," 'f'O AS,~U~(E THAT
<br />AL, L NIEC, ESSARY tNFOR~ATIOI,I,
<br />
<br /> ]:
<br />
<br /> F'LAN REVIEW: BY A_;
<br /> , - ,: e 77--~---:~ , ~ ,.-% . -,--,% .......... , ....................
<br />
<br />EOnM ~ ~C t O-O~ n~v, ~ OF FiCE COPY
<br />
<br />
<br />
|