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MARIONCOUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C · Salem, Oregon 97305-1398 <br />Office Houm: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (50~) 373-4427 <br /> <br /> I~jOR !' <br /> SEPTIC REPAIR PERItIT <br />~9=48 <br /> <br />I~TE/TZME = 82/e6/98 PERNIT HO = 78-~e72! <br />TYPE <br />~CUP~CY = R-3 [SSUED = ~2/~6/~9~ <br /> TO EXP[~ = B2/~6/~9 <br /> P~E <br /> <br />WORK DESC : AUTH/MAJ FOR MINOR PARTITION <br /> <br />~TE ADDRESS : CITY: MARION COUNTY ~224 SHAW SO SE AM <br /> <br />SUBDIVISION : LOl: I BLOCK: <br /> <br />CROSS STREET : SILVER FALLS HY SE <br /> <br />PARCEL NUMBER : 753~0-810 <br /> PARCEL SIZE : 4.&AC <br /> <br />PROPERTY LOCATOR: 082WI~D 01800 <br /> ZONE: AR <br /> <br />OWNER NAME : POTTER MONROE J & MILDRED S <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br />PHONE <br /> <br />POTTER MONROE J & MILDRED S <br />9224 SHAW SQ RD <br />AOMSVILLE OR <br /> 97325 <br />362-6~68 <br /> <br />CONTRACTOR/ : POTTER MONROE J & MILDRED S OEO LICENSE: <br /> AGENT : OCCD: <br /> <br />PHONE : <br /> <br />[Inits Description Fee <br />1 Major Repair ~'~' <br />1 Authorization w/Field Visit 217.00 <br />I DEQ Surcharge <br /> <br /> Assessed fees : 247.00 <br /> Adjustnents : .00 <br /> Total fees : 247.00 <br />PAYEE: POTTER MONROE J & MILDRED S Total paxnents: 247.00 <br /> Balance Uue : .00 <br /> <br />THIS PERHIT IS NON~TR~14SFERABLE P~ID EXPIRES 345 DAYS FRO/~ ISSUE DATE IF WORK HAS NOT <br />UKuzm~--~J~SOR IF #ORK FAILS TO NEET ALL REGUIREMEHTS OF STATE LA#S AND H~R[ON COUNTY <br /> <br />~ONAL. D E WOODLEY~ MARION COUNTY BUILDING OFFICIAL / BY PMUNRO~/ <br /> <br /> <br />