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MARION COUNTY BUILDING iNSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C · SMem, Oregon 97305-1398 <br /> Office Hour~: 8:00-4:30 o Phone: (503) 588-5147 · 24..HR InepecUon Line: (503) 373-4427 <br /> <br /> / <br /> · . SEPTIC PERHIT ,, ~// <br />TYPE . SP ~',' <br /> <br />~ORK 1)ESC · AL'T'ERATION FOR NEW 6/~ED NEW DWELL ,~O/ ' '\' '~'~'~ <br />bTTE ADI)RFSS : CITY: MARION COUNTY )C~' ~r/, <br /> 12728 DONALD LOOP RD NE AR <br /> <br />SUBDIVISION : LOT: BLOCK: <br /> <br />CROSS STREET : MARKET <br /> <br />PARCEL NUMBER : 40928-00B <br /> PARCEl: SIZE : 8.~AC <br /> <br />OWNER : GRE~Jq JOE <br /> <br />PROPERTY LOCATOR: 04iW22B 01100 <br /> ZONE: EFU <br /> <br />AIITH AGENT <br />ADDRESS <br /> <br />: ,JOE GREEN INVESTMENT CO. <br />: PO BOX 759 <br /> <br /> PORTLAND, OR 97287 <br />PHONE : 685-76B5 <br /> <br />INSTALLER <br /> <br />DEQ LICENSE: <br /> <br />PHONE : 685-9685 <br /> <br />INITIAL, SYSTEM: STANDARD <br />RE'PLACEMENT SYSTEM: STANDARD <br /> <br />Units Description Fee <br />1 DEQ Surcharge 30.00 <br /> <br /> Assessed fees : 378.88 <br /> Ad~ustments : .80 <br /> Total fees : ~78.08. <br /> Total payments: 378.88 <br /> PAYEE: JOE GREEN INVESTMENT CO Balance ~ue : .08 <br /> <br />THIS PERMIT IS NON-TRANSFERABLE AND EXPIRES 365 DAYS FROM ISSUE DATE IF WORK I~ NOT <br />COHtIEHCED rjr IF #ORK FAILS,TO MEET ALL REGUIREMENT5 OF GTATE LAHS AMD BARTON COUNTY <br />OR~INA~q:ES. ~ <br /> SIGNAI'IIRE OF APPI.ICANT: ........................................... <br /> <br /> ~ONAL~ E WO~DI_EY~ MARION COIINTY BUILDING OFFICIAL. / BY CLYNCH <br /> <br /> <br />