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MARION COUNTY BUILDING INSPECTION <br />COI MIJNll' DEVELOPMENT CENTER <br /> <br />~ATE/TINE <br />TYPE <br />OCCUPANCY <br /> <br /> 285 Chu~h Street NE * R~om 132 ° ~';lem, Oregon 97301.3670 <br /> Office Hours: 8:~0-~:30 · Phone: (5~) ~5147 · 2~HR inspection Line: (5~) <br /> <br />= SP ~PPL[E~ : 1~/21/19~5 <br /> <br />DRAINFIELD REPAIR <br /> <br /> PRDPOSED BEDROOM8 : <br /> PROPOSED EMPLOYEES: <br /> <br />SHORT ST DT <br /> <br />SUBDIVISION : <br />CROSS STREET : <br /> <br />PARCEL NUM~.~R : <br />F.'ARCEL SIZE. : <br /> <br />OWNER <br /> NAHE <br /> AD~RESB :: <br /> <br />PHONE <br /> <br />SANTIAH <br /> <br /> .8 AC <br /> <br />DENSON, H <br />PO BOX <br />SLIBLIMtTY~ <br /> 97~85 <br /> <br />APPLICANT <br />NAME DEHSON, H D & BHIRLEY E <br />ADDRESS ~ PO BOX 245 <br /> S[JBLIMZTY, OR <br /> <br />DEQ COflTRASTOE: DEN~OH~ H D & SHIRLEY E <br /> / A~ENT : ~Efl~ON~ H D & SHIRLEY E <br /> F'HDNE : 769 <br /> <br /> 1 DEQ Su <br /> <br />CII/, DETROIT <br /> <br />BLOCK <br /> <br />DE~ LICENSE. <br /> <br />~s~essed (ees <br />daus~ent~ <br /> <br />210.00 <br /> .00 <br />210:.00 <br /> .00 <br /> <br /> ~Q~al p aymerlt,~; <br /> atay)ce due : ~J.O. 00 <br /> F'AYE:E: D~NSON. H D & SHIRLEY E ......... <br /> <br /> THIS IS HOT A PERMIT. THiS APPLICATION F~U~T r.~ ll~ROUGH A REVIE~ PROCESS WHERE <br /> SO/L~ ~ERSAB/L/TY AND iNSTAt.tJ%TIO~J RE~UIP. E]flEHTS ARE CHECKED PRIOR TO THE ~SSUANCE <br /> OF n PERMIT. IT IS THE RESPONSIBILITY ~'T~ ~ICAHT TO ASSURE THAT flL <br /> HE~flRY IHFO~MAT~ON IS PROVI~. tis S~H A~ A~ REQUIREMENTS oF THE REVIEW <br /> HAVE ~EEH ~ET~ Y~ U~LL ~ NGTZFZE9. <br /> <br /> DONALD g. WO(JI)[.EY, MARION COUNTY BUILDIHG-:DFFICI~ / BY PHLII,IEO <br /> <br />................ FO~ OFFICE USE ONLY. TH[~,I~S HOT A PERfllT ................. <br /> <br /> SEPTIC REVIEW: DATE: ~OHING REVIEW= <br /> <br /> <br />