Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREPT NE <br /> SALEM, OREGON 97'301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904- <br /> <br />The work will be PePtormed by a registered buiider. <br />Other__ <br /> <br />HUSSEY, ALAN <br /> <br />~C©'f"~' AVE: <br /> OR <br /> <br />UGB <br /> <br />,OET'F~O.[ NO <br /> <br />PAll'ON .. <br /> <br /> RES[OENI[AL <br /> <br />OCCUPANT LOAB <br /> <br />LOT PHONE: 8'5~--'~ S~CTION <br /> <br />WIDTH DEPTH. AREA <br /> <br />'!00 135 13500. <br /> <br />SF NO YES <br /> <br />'}'YPE:: ON-SI'f'E ~EWAGE <br /> <br />PERIVli'F OR APPLiCAf'ION NO: 903350'1 <br /> <br />CON'fRACf'OR, NO. 35916 <br />STAYrON MILL CITY SiLVERTON SEP <br />&1'/55 S'fAY'ION ~i0 DRIVE, SE <br />S FAY I'ON, OREGON 9?383 <br />~ONE: 769~2302 <br /> <br />WATER ~UPPLY: PW <br />I'EST HOLES READY: <br />SITE EYALUA'fION NUMBER: <br />EXJSf'~NG TANK SIZE: <br />E~I~'FING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PR~iOU~ NO. 8EDRO(2~S: <br /> <br />IT'EM ~,/ QUANIi¥'Y AJ'~:)UN'I' <br />REPAIR ~ ~AJOR f3'~.~ 1 $80.09 <br /> ~ TOTAL A~gSSEDFEES $8L),0~ <br /> ~_~ PREVIOUS RECEZP'FS <br /> THiS RECEIPT $80.09 <br /> <br /> 35~19 <br /> <br />BALANCE: DUE <br /> <br /> PAYE~: I$'I'AYI'(,~N MiLL CITY SiLVERI'ON ~EP]'iC, INVOICE NO: <br /> RECEIVEU BY: CL ........................................................................................................... TYPE: IN C~ECK ~: 0 <br /> <br /> SEE A) I ACHEO OOCU~EN'f FOR REQU[R~'('S OF ON-,SI'rE SENAGE 5YS'~'EM, <br /> <br />:~ THiS IS NOT A PE~IT. THI~ APPLI~TI~ ~T ~ TH~ A R~I$ P~ ~ERE THE <br />~OLL~iNG ~T BE ~PLETED. IT I~ THE R~/~ILITY OF THE APPLI~T TO ~RE I'HAT <br />ALL NEC~RY INFO~TI~ H~ BE~ P~EO. <br /> <br /> PL~ R,~VIEW: BY ............. _~ DATE~'[~-~[ C~'f'Y JUR~S~tC'fiON: BY DA'f~ <br /> REMARKS: REPAIR <br /> <br />FOR~ ~ MC is-se n~v. ,~ OFFICE COPY <br /> <br /> <br />