Laserfiche WebLink
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 />~ 8m performlf/9 work on a property I own or occupy, <br />I am a registered builder OR the authorized representative <br />of a registered builder, · <br />The work will be performed by a registered builder. ' <br />Other <br /> <br />DATE: <br /> <br /> ' ~Ol~l~-~AdT' ~i~i .... "O~i ....................., OCCUPANT LOAD: <br />: 12235 WEST STAYTON RD SE ~ ' ~ <br />: AHMSVI.LI, E O~ .B2~2.5 , ~IOE COU~'[~ ,NO ........ ~ <br /> <br /> SITE NUMBER: 94-82391 <br /> PHONE: 769-324~ ! VALUATION: <br /> <br />w DTH !DEPTH: ~ A~: ~ UNt~ I I~G, LOT; CC~; <br /> <br />TYPE: OH-S~TE SEWAGE <br /> <br />PERHZT OR APPLICATION <br /> <br />CONI'RACTOR~ NO,, <br />WOOSI. EY, ALLEN & KAY <br /> <br />PHONE: <br /> <br />WATER SUPPLY: De <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED: <br />PREVIOUS NO. BEDROOMS: 2 <br /> <br /> QUANTITY AMOUNT <br />AOTNO . TION HOTiC - viSiT <br /> <br /> TOTAL ASS SSE EE, <br /> PREVIOUS RECEIPTS $0,,00 <br /> THIS RECEIPT $160.00 <br /> <br /> BALANCE DUE $0,00 <br /> <br />PAYEE. WOOSLEY. ALLEN ~ KAY RECEIPT NO: <br />RECEIVED BY: cl TYPE: CK CHECK ~: 167 <br /> <br />~ THIS IS NOT ~ PERMIT. TNI~ APPLICATION HUST GO THROUGH ~ REVIEW PROCESS WHERE THE <br /> L [ ~ "l' . ' PETED IT IS THE REGPONSIBILITY OF THE APPLICANT TO ASSWRE TNAT <br /> <br />PL. AN REVIEW: <br />REMARKS: <br /> <br />BY .......... DA CITY JURISDICTION. BY DATE <br /> <br /> OFFICE COPY <br />FORM # MD 15-56 REV, 4,90 <br /> <br /> <br />