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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N,E, · Suite C · Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Erie: (503) 373-4427 <br /> <br /> SEPTIC PERHZT f / t <br /> <br /> 8~4~ DARLEY RD ~E AH ~~ <br />SIJ~OIV]S[OH = LOT~ BLOCKm <br />CROSS STRFFT : CORNER OF BRICK RD EAST DH D~ELEY BEFOG HEAL RD-SOUTH~DE <br />PARCEL NUHBER'. ~1~22-~1 PROPERTY LOCATOR: ~?2~X4D a~79~,/k <br /> PARCEL SIZE m &e.~AC <br /> ZONE~ EFU -- / ~/ <br />O~HER = FLAGER GARY x ~ ~ ~~ <br />AUTH AGENT = FLAG~ GARY / ~ ~ <br />ADDRESS m 5966 BACELONA OR SE <br /> SALEM OREGON <br />PHONE ~ 5B3-58~-9~9 973ei <br /> <br />O[Q ~NSTALLER : ~ANI-TECH OEQ LICENSE~ 35767 <br /> <br />PHONE : (5B3) 364-747e <br /> <br />INITIAL SYSTEM: PRESSURE DISTRIBUTION <br />RFPLACEHENT SYSTEHm PRESSURE DISTRIBUTION <br /> <br />Units Description Fee <br />z uonstructzen ~ermzt <br />1 OEO Surcharge <br /> <br /> Assessed fees m <br /> Adjustments ~ <br /> Total fees ~ <br /> Total pax~ents~ <br /> PAYEE~ FLAGER GARY Balance Uue = .Be <br /> <br />THIS PERHIT IS NON-TRAN.qFERABLE ~ EXPIRES 3&5 DAYS FROH I~UEDATE IF MORK i~S NOT <br />CGHitEI, KiE~,OR.IF WORK FAILS TDHEETN.L*REGUIREflENTSOF STATELAMS 4Nl I'M~ION CIRINTY <br /> <br /> SIGNATURE OF APPLICANT: <br /> <br /> DONALD E NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY PMUNR0~t,~' <br /> <br /> <br />