Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br />.SALEM, OREGON 97;301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: fi88-7904 <br /> <br /> o a regis ered builder- <br />) The work wiM be p¢¢formed by ~ regJa{ered bui]der. <br /> <br />SIGNATURE OF APPLICANT; . . . <br /> <br /> 864Z SHAW 8QUAr4E RD SE <br />AUHSVILLE OR ~7~25 MARION 60UHTY, NO <br /> ~0 o~ ~onoo~s: <br /> <br />PHONE: 588-8155 <br /> <br />VALUATION: <br /> <br />4? <br /> <br />TYPE: ON-SITE SElf,GE <br /> <br />PERf~IT OR APPLICATION NO-* <br /> <br />CON'fRACTOF<~ NO. 04164 <br />Adoloh H Scharff <br />1ED Cordo~ Rd NE <br /> <br />4714~ <br /> <br />WATER SUPPLY: F'W <br />TEST HOLE~ READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXIST~M6 D~AIN FIEL9 LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. <br /> <br />;TEH QUANTITY AMOUNT <br />REPAIR - HI:NOR <br /> <br /> TOTAL AE~ESSED FEES $85,00 <br /> PREVIOUS RECEIPTS $85.00 <br /> THiS RECEIPT $0.00 <br /> <br />BALANCE I)UE $0.08 <br /> <br />PAYEE." RECEIPT <br />RECE;~,VED BY:~ TYPE: ,._.Hr_C,K <br /> <br /> SEE ATTACHED ~OCUHENT FOR ~Et~UIREMENTS OF ON-SITE SEWAGE SYSTEH,, <br /> <br />CONSTRUCTION FAILS TO MEET ALL REOUIREMEI'IT8 OF STATE LAWS AND I4ARION COiJNTY BU~TLDII,IG AIqD <br />ZONIN~ ORDIHANCES, TH~'S F'~RMIT SHALL ~EOOHE NULL AHD VOID. <br /> <br /> KEI'tAEKS. REP:MTN <br /> <br />,!)ONAL~ E. WOODL. EY~ MARZL'3N COUNTY BUILI)II,i{;¢ OFFICIAL / BY <br /> <br />FORM # MC 1~-t~3 REV, 4/90 <br /> <br />OFFICE COPY <br /> <br /> <br />