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SESPNEW - 1503090
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SESPNEW - 1503090
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Entry Properties
Last modified
2/9/2010 10:55:38 AM
Creation date
10/12/2004 7:29:39 AM
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Template:
Permits
Permit Address
9224 SHAW SQ SE
Permit City
Aumsville
Permit Number
555-98-00721
Parcel Number
082W13D 01800
Permit Type
SESPNEW
Permit Doc Type
Permit Document
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,AIarion ,Countt; <br /> <br /> SEPTIC TANK ABANDONMENT <br /> <br />TH]i SBPTIC TANK AT: <br /> <br />5224 <br /> <br />ACTIVITY NUMBER: <br /> <br />98-00721 ,. <br /> <br />WAS PUMP]/D BY: <br /> <br />DATE TANK PUMPED: <br /> <br />, Carls Septic <br />(li~nsed D, £.Q. pumper) <br /> <br />6-1 -98 <br /> <br />THE TANK WAS: <br /> [ ] KEMOVED <br /> <br />FILLED <br />(note: the bottom of the tank should be perforated or cracked to <br />prohibit the accumulation of surface water in the tank) <br /> <br />FILL MATERIAL: <br /> [ ] REJECT SAND <br /> [:a] BAR RUN GRAVEL <br /> [ ] CRUSHED ROCK <br /> [ ] OTHER: <br /> <br />ENCLOSE A COPY OF THE PUMPING RECEIPT WITH THIS FORM. <br /> <br />COMPANY NAME: Lone Pine Corner Inc. <br /> <br />Marion County Building Inspection <br />3150 Lancaster Dr. NE, Suit~ C <br />Salem, Oregon 97305-1398 <br /> Phone: 588-5147 <br /> <br />aba~:lon, mk 4/97 <br />MC-15-~2 <br /> <br /> <br />
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