Laserfiche WebLink
33— c5z)0\9. \- -a-ct_p <br /> MARION COUNTY ItuiLpiNg INSPECTION DIVISION <br /> SI55:SilvertOn <br /> $,41 .m Olt 07, 05. TEC -P -vrni <br /> .(503)$$$,,514 1 <br /> tax;.(40),;0 .:7948- MAY 1 9 2023 <br /> MARION COUNTY <br /> • BUILDING INSPECTION <br /> LAND Org:0*.cwwirry STATEMENT(WO). <br /> FOR ON-SITE ..E3,784,G.E.8)(81700 <br /> frot: .4126 :27 , MCBE File It: <br /> rSECTION —APPLICANT LNFORMATION. <br /> I. -Frepetty AdifressjoSC 1:46 V\\A.Y1 15'roperty <br /> \KIWdA6V1r) .0)A 971 D11. <br /> • ;SOii0.11: OS TC-Whship: kV] Rangp.:.k 41 N. <br /> Nal=of Applicant: -Pt!6'1,0"-ka.n., On. Tolephonc.#: &a:Ct) '(:)- <br /> r.„ <br /> Mailing Address IS. Hu.:3\1: .6/. <br /> _ ).S7s <br /> 'Describe type of racilliy-the ch-Site sewage.system Will,SerVe.(busilieg,:reOdettce:or.o.therY: <br /> P Single FàthII apiidetice, <br /> • BusinesS. <br /> 0.Other: <br /> 4, Type or on-site sewage system permit apptication:.beiogproptige'd for this property: <br /> `16 New.Installation Permit orAckl <br /> :12 Repair Nirmit <br /> O Alteration Permitfor C1 Replacement Dwelling 0 1iteclrooro(s),additioxr <br /> O Other eiltqws in lanci.use invthing:poter4)sewage flow increase <br /> diTORtaNg.ErricAppikit Llie.S.doc MC S49!ieyir /1 0,.04112. <br /> RECEIVE <br /> APR 2.5 2023. <br /> cofvutiNnY bEvELoPmENT <br /> DEP?.IRTNIFAT <br />