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Marion County <br /> 5155 Silverton Rd NE <br /> 17ation CERTIFICATE OF SATISFACTORY Salem,OR 97305 <br /> Gaunt 503-588-5147 <br /> E COMPLETION Fax: 503-588-7948 <br /> Residential Septic <br /> Permit Number: 555-13-005279-SEP <br /> Web Address:www.co.marion.or.us Email Address: building©co.marion.or.us <br /> Permit Issued: 09/10/2013 Permit Finaled: 03/12/2019 <br /> TYPEOP WORK <br /> tics max .... <br /> V,,,�7.,��«„�'",`.u_ _. �m,+.,,�"��4 L ��;-.� e,.,��U: ,, <br /> Category of Construction:Single Family Dwelling Type of Work:Permit Renewal <br /> Submitted Job Value:$0.00 <br /> Description of Work:RENEWAL OF INSTALL 08-00246&CHG FROM SAND FILTER TO ATT <br /> ?OB SITE INFORMATION ..._ _ .. .. <br /> Worksite Address Parcel Owner: SHARABARIN,MARINA M <br /> 14530 NIKITA LN NE 061W25C 01001 Address: 29855 S HIGHWAY 213 <br /> SILVERTON,OR 97381 MOLALLA,OR 97038 <br /> Item Description Item Group Quantity <br /> DEQ surcharge SEPTIC 1 <br /> Hourly inspection rate SEPTIC 2 <br /> Permit renewals without field visit SEPTIC 1 <br /> Pump system-in addition to permit fee SEPTIC 1 <br /> �.eg �^`' � ,��e�5,� �. �"� o ✓k^i�w-E rte- ���� r' aa � "�..�a"- <br /> Business Name License# Expiration Date Phone# Contractor Name <br /> JIM HICKS EXCAVATING INC 98043 2020-05-19 5032665975 <br /> INSPECTIONS COMPLETED '4a <br /> Inspection Type Date of Inspection Inspector <br /> 7999 Final Inspection 2019-02-11 Claudia Hill <br /> 7020 Pre-cover 2013-09-25 Matt Knudsen <br /> 7100 Septic Tank 2013-09-25 Jessica Joye <br /> 7450 Drainfield 2013-09-25 Jessica Joye <br /> 7460 Drainfield Cap 2019-02-11 Claudia Hill <br /> Printed on:3/12/2019 Page 1 of 1 C:\myReports/reports//production/01 STANDARD <br />