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 OODE-A-PHONE: 588-7904 <br /> <br />Other <br /> <br /> ~O~U~ANt LOAO: <br /> <br /> PHONE: ' ') ~ SITE NUMBER: 94-134~74 <br /> 749-18~2 i VALUATION: <br /> <br />~ ........... / o~ ........ I .o NO <br /> ...... L <br /> <br />TYPE: OH~SITE SEWAGE <br /> <br />PER~iT OR APPLICATION HO~ 9B&S~77 <br /> <br />CONTRACTOR. NO. <br />CASCADE INSERNATION SEE9 COMPAN <br /> <br />PHONE: 749-1822 <br /> <br />WATER SUPPLY <br />TEST HOLES REACT: <br />SITE EVALUATION NUMBE~: <br />EXISTING TANK SIZE: 1000 <br />EXISTING DRAIN FIELD LINES: , <br />SEPTIC TANK PUMPED: J~131~-~O~L~ <br />PREVIOUS NO, BE~ROOHS: <br /> <br />300 <br /> <br /> ITEM QUANTITY AMOUNT <br /> AUTHORIZATION NOTICE -FLD. VISIT ;[ <br /> <br /> TOTAL ASSESSES FEES <br /> P~EVIOUS RECEIPTS <br /> THISRE:CEIPT <br /> <br /> BALANCE DUE <br /> <br /> PAYEE: CASCAQE INTERNATION SEEO COMPANY: RECEIPT NO: 62&'?~ <br /> RECEIVED BY: JS TYPE: CK CHECK 8: <br /> SEE A'FTAONED DOCUMENT FOR REQUIREMEN~ OF ON-SITE SEWAGE SYSTEM. <br /> <br /> * THIS IS NOT A PER~IT. THIS ~PPLICATION, HUST §0 THROUGH A REVIE~ PROCESS WHERE THE <br />FOLLOWING ~OST BE COMPLETED. IT IB,,~NE RESPOHSIBItITY OF THE APPLICANT TO ASSCRE THAT <br />ALL HEL~SA~Y INFORH~T~ON HaS ~EN 'P~OV~DE~. <br /> <br /> PLAN REVIEW~ BY DATE <br /> 8ITl JURISDICTION: BY .................. DA'rE .................. <br /> <br /> ", · ,o. <br /> Rt,~Akk;, AUTH W/ VISIT $$NEEDS PUMPER FORM~* <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV, 4/9O <br /> <br /> <br />