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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br />,SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I ,sm performing work on a property I own or occupy. <br />lam aregisteredbulfderOR( } the authorized representative <br />of a registered builder, <br />The work will be porformed by ~ registered builder, <br />Othor_ <br /> <br /> DATE: 12/09/92 rIME: 12:02:29 <br />OWNER: <br /> BRU[:;E pACt, iN6 COMPANY t BRUCE PACK) <br /> <br /> DATE· <br />GONSTRUCTION TYPE <br /> <br /> 12264 SILVER FALL3 HWY <br /> AUMSVILLE OR <br /> <br />USE OF BUILDING: <br /> <br />MAILING ADDRESS: <br /> <br /> SANE <br /> <br /> PMONE: 769-21~9 <br /> <br /> .... GONTRACT GITY' UGB: <br />97325 MARION COt_I~TV NU <br /> <br />4EAT PROCESSIN6 PLANT <br /> <br /> SITE NUMBER: 92-04214 <br /> VA[.UATION: <br /> <br />22 8S iA EFU <br /> NU NO <br /> <br />CATEGORY: <br /> COMMERCIAL. <br />OCcuPANcY: <br /> <br />O~GUPANT LOAD; <br /> 84 <br /> <br />MAP: <br /> <br /> q7 <br /> <br />TYPE: ON-SITE SEWAGE I WATER SUPPLY: <br /> ' TEST HOLES READY: <br />PERMIT OR APPLICATION NO: 9044312 I SITE EVALUATION NUMBER: <br /> I EX]STING TANK SIZE: <br />CONTRACTOR, NO. I EXISTING ORAIN FIELO LINES: <br /> t SEPTIC TANK PUMPEO: <br />BRUCE PACKING COMPANY (BRUCE PA I PREVIOUS NO. BEDROOMS: <br />SAME ] <br />PI-lONE: 769-2139 I <br /> <br /> ITEM QUANTITY AMOUN1 <br /> AUTNORIZATION NOTICE '- FIELD VISIT 1 <br /> <br /> TOTAL. ASSESSED FEES <br /> PREVIOUS RECEIPTS $0,,00 <br /> THIS RECEIPT $0.00 <br /> ·, 8'A~ANCE DUE $150,00 <br /> <br /> PAYEE: RECEIPT NO: <br /> RECEiVEO BY: CL_ ....................................... TYPE: CHECK ~: 0 <br /> <br /> BEE ATTACNED DOCUMENT FOR REQUIREMENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />· THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUSI' BE COMPLETEO. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAI' <br />ALL NE(;EBSARY INFORMATION NAS BEEN PROVIOEO. <br /> <br />PLAN REVIEW; BY ................ DATE ............. CITY JURISDICTION; BY .............. DATE ................ <br /> <br />REMARKB: AUI'M / PROPOSED LUNCM RM & NEW OFFICE NFG UNITS TO 8ITE EXISTING ~ OF' <br /> EMPI,,,OYEEG IS 70 (NOT PAID) <br /> <br /> OFFICE COPY <br />FORM # MC 15,56 ¢¢EV. 4/9O <br /> <br /> <br />