Laserfiche WebLink
:IVIARION'COUIN'TY BUILDING INSPECTION DIVIS, <br /> 5155-Sliverton 144"NE <br /> LI <br /> Salem Olt:9705 • OCT 0.4 2023 <br /> (503)5884147 <br /> Fax:(503)488-1940 fv1,ARION COUNTY <br /> BUILDING INSPECTION <br /> LAND USEstOIVIkATIBILITYSTATEIVIENT(LUCS) <br /> POICON-SITE SEWAGE SYSTEMS <br /> MtBI File th <br /> sEcrioN ucANT woRmAnoN <br /> r. 'Property Address: 3 JO J t /4.1 e Pj Property ID it: <br /> 'Section: Township:. Range: Tax Lot#:• <br /> etx 2. garnentApplicant Telephone4: <br /> MailingAddress: <br /> 3. Describe type of facility the on-site sewagezyStem will,serve(business,residence-or other): <br /> ' SJnilyRi4ence <br /> U Business <br /> C3 Other: <br /> 4 Tyl3e.of on-site sewage system permit applicationbeing.proposed for this property: <br /> \I:410w InstallatiOn Permit <br /> ftegOirPOgoit- <br /> AlteratiOn Perniit.fort U Replacement Dwelling -0"Bedroom(s)addition <br /> GI Other changes inland use involving potential sewage flow increase <br /> GAFORMSISEPTICApplicatibirPaekets1S-3911JCSAtie MC:-S-39 reit:VIO,04/12 <br />