Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SE.NATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 5S8-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work Qn 8 property I own or Occupy. <br />I am a registered builder OR he authorized re;) esen a ye <br />of a registered builder, <br />The work will be per;or*ned by a registered builder. <br />Other <br />I have reed and agree to ~he terms stated on the reverse side of <br /> <br /> DATE: 10/09/92 TINE: 16:i9:09 <br /> <br /> ROSE, FRRNKLIN i , RESIDENTIAL <br />ADDRE$$~ <br /> <br /> :[1~;44 JAMES WAY BE <br /> AUHSVILLE OR 97525 <br /> <br />5210 RIVER ROAD N ~1000 ! ...................................................... <br />KEIZER 97505 OFFICE 593-3624 X-$50 i SITE NUMBER: 92~0~i99 <br />PHONE: 590-9355 I VALUATION: <br /> <br />TYPE: ON-SITE SEWAGE <br />PERMIT OR APPLICATION NO: 42400 <br /> <br />CONTRACTOR, NO. <br />ROSE~ FRANKLIN <br />5210 RIVER ROAD N ~lO00 <br />KEIZER 97~0~ OFFICE ~93-3624 X- <br />PHONE: 590~9553 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />BITE EVALUATION NUMBER: 28245 <br />EXISTING TANK SIZE: <br />EXISTING ORAIN 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 $21o.oo <br /> PREVIOUS. RE'CEIPTS $210.00 <br /> THIS RECEIPT BO.O0 <br /> <br /> 8ALRN'CEDUE $0100 <br /> PAYEE: RECEIPT NO: <br /> RECEIVED BY: cP_ TYPE: CHECK ~: 0 <br /> SEE ATTACHEO DOCUMENT FOR,REQUI:RENENTS:OF:ON-SITE ,SEWAGE SYSTEH. <br /> <br />* THIS IS A VALID PERMIT ~ 'THIS,PERMIT EXPIRES'~60 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION FAILS TO MEET ALL REQUIREHENTS' OF'STATE LA~S AND MARION COUNTY BUILDING AND <br />ZONING ORDINANCES, THIS PERMIT 'SHALL BECOME NULL AND VOID, <br /> <br />RENARKSt <br />DONALD E. WOODLEY~ NARION'oouNTy BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 1~ REV, 4~ <br /> <br /> <br />