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11911650
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11911650
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Last modified
10/25/2023 8:00:13 PM
Creation date
10/25/2023 1:58:48 PM
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Template:
Permits
Permit Address
22988 NORTH FORK RD SE
Permit City
Lyons
Permit Number
555-23-004442-AUTH
Parcel Number
092E17BC01600
Permit Type
Authorization
Permit Doc Type
Permit Document
Status
Ready to Film
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Marion County a Certificate of Satisfactory Completion 5155 Silverton Rd NE <br /> MarionSalem, OR 97305 <br /> county; Repair (Minor) - Residential - New 503-588-5147 <br /> Building@co.marion.or.us <br /> O R e:c 0'N 555-23-004442-PRMT-01 Website:co.marion.or.us <br /> Date Cent ficate issued:10/16/2023 ` ` � :.�.,.. 1� ; ` '1. <br /> L"�" Ff fie"� v Y'* ` .�4 � r -� � �` 'a'�� M <br /> r <br /> Work Description: RE-MIN=RE=P:REP 'BURNED 3BD SFQ 1Nl} 3BQ Sf$D 07 <br /> y <br /> a �� ''. q- ." .tis `" � �„ .v`<- s gas` s'y i ` �, `�`. ,'e .. .,' ��" " *"*`,",�.:,,,, ,4s q s ,: <br /> �Tt.;,..�;�„rf , , ,. . � ��� � � . .., �� w.,m. F �.. <br /> Applicant: Shafer, Daniel Primary Contractor:Daniel Shafer <br /> Address: 8044 Wheatland Rd.N DEQ Installer/Maintenance Provider: M466 <br /> Keizer OR 97303 Address: 8044 Wheatland Rd.N <br /> Phone: (971)600-5469 Keizer OR 97303 <br /> Email: OFFICE@SANTIAMSEPTIC.COM <br /> Phone: (971)600-5469 <br /> Owner: DEATLEY,JAMES W(LE) Property Address: 22988 North Fork Rd SE, Lyons,OR <br /> Address: 1705 CHEMEKETA ST NE 97358 <br /> SALEM OR 97301 <br /> Parcel:092E17BC01600-Primary <br /> Lot Size: N/A Water Supply: Community Water Supply <br /> Zoning: N/A City/County/UGB: N/A <br /> Land Use Approval: N/A <br /> Category of Construction: N/A <br /> ti <br /> . <br /> Use of Structure: N/A 3 bedroom home <br /> Number of Bedrooms: N/A 3 <br /> System Specifications <br /> Type: Alternative <br /> Special Tank Requirements: needs control panel replacement <br /> 10/16/23:11:12:54AM ONS_OnsiteCSCpr <br />
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