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MARION COUNTY BUILDING INSPECTION <br />COMMUNIT DEVELOPMENT CENTER <br /> <br /> 285ChurchStmetNE-Room132oSalem, Omgon ~301-3~0 <br /> OfflceHours:8:00-4:30.Phone:(503)588~147-2~HRInspectionLine:(~3)373-4427 <br /> <br /> SEPTIC PERNIT <br />RATE/TIHE = ~1/38/97 11:23 PERH[T NO = 96-88241 <br />TYPE : SP ST&TUS : ISSUED <br />OCCUPANCY = R-3 ISSUED = B1/3B/1997 <br /> TO EXPIRE = 81/38/1978 <br /> <br />WORK DESC : SP:INSTALL FOR FURTURE MAflFG-~-BDRM HOME <br /> <br />S~TE ADDRESS : CITY: MARION COUNTY 10647 LEVERMAN RD SE AM <br /> <br />SHBDIVISION : LOT: BLOCK: <br />CROSS STREET : MILL CREEK RD SE <br /> <br />PARCEL NUMBER : 56466-25~ PROPERTY LOCATOR: 081W29C 02680 <br /> PARCEL. SIZE : 2.5AC ZONE: AR <br /> <br />OWNER : CONKLIN~ RALPH & PATRtCIA <br /> <br />i AUTH AGENT <br /> ADPRESS <br /> <br /> PHOHE : <br /> <br />llFQ INSTAtLER : S*IAYTON~ ML CTY & SILVERTON SEDEQ LICENSE. ~4916 <br /> <br />PHONE : (5~3) 769-2302 <br /> <br />TNITIAL SYSTEM: STANI)AR~ <br />REPLACEMENT SYSTEM: SAND FILTER <br /> <br />U~its Desolation Fee <br />--I Cons~~ iTS~.-Bl~ <br />~ DEQ S~lrcharge 30.08 <br /> <br /> Assessed fees 38~.08 <br /> Ad justme~ts .80 <br /> Total fees 382.88 <br /> Total pay~ents: 382.08 <br /> PAYEE: B~laoce due : .08 <br /> C[ NK[ ~N~FATRICIA <br /> <br />THIS P£RNIT ~S NON-TRANSFERABLE AND EXPTRES ~&5 DAYS FROH ~SSUE DATE IF WORK HAS NOT <br />COHHEHCED OR IF UORK FAILS TO NEET N-L REGUIRENENTS OF STATE LAWS AHD RARION COUNTY <br />ORD~HW~NC£S. <br /> <br /> SIGNATURE OF APPLICANT: <br /> <br /> ************************************************************************************** <br /> DONAI.D E WOODLEY, MARION COONTY BUILDING OFFICIAl._ / BY PRYON ~. ~--' <br /> <br /> <br />