Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-S147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am a registered builder OR ( ) the authorized representative <br />Other. <br /> <br /> t have read and agree to the terms stated on the reverse side of <br /> this documerl[ <br /> <br /> DATE: 09/04/92 TIME; 16:$6;04 <br />OWNER: <br /> LIFFLANDER, JOHN & CAROL <br /> <br />57665~000 <br /> <br />RESIDENTIAL <br /> <br /> 8851 SMITH RD <br />AUMSVILLE <br /> <br /> SE <br />OR 97~25 <br /> <br />OCCUPANT LOAD: <br /> <br />MAILING ADDRESS: <br /> <br />5290 8ALSAM DR S <br />SALEM OR 97302 <br />PHONE: 563-6418 <br /> <br />WK 378-3738 <br /> <br />SITE NUMBER: <br />VALUATION: <br /> <br />92-01640 <br /> <br />LOT: BLOCK SECTtON: <br /> 24 <br /> <br />TOWNSHIP: RANGE. ZONE <br />8S 2W SA <br />UNIT~:c I~b~ LOT: CORNERNo <br /> <br />TYPE: ON-SITE SE#AGE <br /> <br />PERMIT OR APPLiCATIOH NO: 42Z18 <br /> <br />CONTRACTOR, NO. <br />LIFFLANDER, JOHN & CAROL <br />3290 BALSAM DR S <br />SALEM OR 97502 WK ~78-5738 <br />PHONE: ~63-6418 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: 39804 <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY AMOUNT <br />STANDARD ON-SITE SYSTEM i $210.00 <br /> <br />'TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$210.00 <br />$210.00 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE; RECEIPT NO: <br /> TYPE: CHECK <br /> <br /> RECEIVED BY: DM2 ................................. 0 <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />· THIS IS A VALID PERMIT * THIS PERHIT EXPIRES 560 DRYS FROH ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO MEET ALL REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PERMIT SHALL BECOME NULL ANO VOIO. <br /> <br />REMARKS: PERMIT <br /> <br />DONALD E. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM ~ MC 19-95 REV, 4790 <br /> <br /> <br />