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 - 4:80 <br />24 HOUR CODE-A-PHONE: 5,~8-7904 <br /> <br /> I am a regis;tared builder OR ) the authori:ed repreFent&tlve SIGNATURE OF APPLICANT; .......................... <br /> of a registered ~ullder. <br /> The wgrk will be ~Ormed by'a registe~d builder. <br /> <br /> DATE; .. 06~¢~. ................. 7_[.~ ~_ ~j 15%]& ...................................................................... <br /> '~N~R; .... '; TAX LOT: <br /> ~THi~ BUiLDiNG ~ <br /> ........................................................... ~'&b'6~¥~l%~'W~: ............................. ~ ........ <br /> ~ifd~ AG~U~,I' ' ~ ~ OCCUPANCY: <br /> <br /> 14979 ~E~O ST ~ ' ........................ {"dSg~ ......... <br /> ~u ' <br /> ~RA OR 97002 <br /> <br /> ~"'d~' '6 QrCd'l ~&'~ .......................................................... <br /> ...................... , , .,~ ......................................... ~ ................................................. .. ~, ,, .,, ,.--.-.~.. ...................... <br /> <br /> ~E ~ <br /> I VA~A T <br />~o~ ........... ?oe~, ......... !~,r~ ~/owus.,~: [.~'~7 ........................... ~'~ .................. :~x,,. ......... <br /> <br />Wl0TH', ?~r~ ........ t ~R~A: ~ U~TS: ~R~G, LOT; ' <br /> ~' ~ ,~ AC i NO ii NO <br /> <br /> 'tYPE= ~SJTE S~G6 NAT~ <br /> <br />PERMIT OR APPLICATION NOt <br /> <br />OONTRAC'roR, NO. <br />PYTHIAN BUILDING <br /> <br />40598 <br /> <br /> TE~T HOLR~ RE~DY~ <br />SiTE EVALUATION NUI~SER: <br />EXiSTiNG TANK SIZE: <br />E,.~iSTiNG DRAIN FIELD LINP.-~ <br />SEPTIC T~K ~MPED: <br />'PR~i~8 NO.'BED~= <br /> <br /> iTP.~ ........ ~JAN'f'ITY AMOUNT <br /> STD ONSiTE SYS < 1000 ~AL . .. .. . . 1 $210.0~ <br /> <br /> · '. ''' PR.E~.u~OU~.'RECEIPT$ $210.00 <br /> :TRI'~:R~Ei:p'f' '.. . $o.o0 <br /> : ': '..:}~[','8A~OE,,,~6' $0.00 <br /> PAYEE: ......... ],:.','.i''],, ,' iNVOiCE NO: <br /> RECEtVEO BYt ~ ..... :'' TYPE: ' ~K ~: 0 <br /> ............. <br /> SEE ATT~ED <br /> <br />~ZJ~,FAZ~ TO ~f,~b',R~m~mm'o¢ STATE.'.'~...~D ~e[m ~T~ eUZLSZNe~ <br /> <br />C'O~ERCI <br /> <br />REMARKS: REPAIR <br />DONALD E. NOODLE¥, MARiON'-C(X~NT¥ 8UiLOING OFF'ICIAL..'~ BY <br /> <br />COPY <br /> <br /> <br />