Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 5@8-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am perforr~ir~g work On a property I OWn or <br />lamaregisteredbullderOR( ) the authorized representative <br />of a registered builder. <br />The work wilt be performed by a registered builder. <br />Other <br />I have read 8nd agree to the terms stated on the reverse side of <br />this document. <br /> <br />i lOl&3 HILL CREEK RI) SE , ¢ONTRAOT OIYY: i UG8; I OCCUPANT LOAO; <br />,I AUMSVILLE OR 97;25-- ~ARION COUNTY KO ' <br />U$6 OF BglLOING; <br /> <br />SAME <br /> SITE NUitBER: 94-04185 <br />PNOWE: 74~-1818 VALUATION: <br /> <br />12.~ -%- - ~O~ SF ~E~ NO <br /> <br />TYPE: OM-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION HO: <br /> <br />CONTRACTOR,~NO. 34916 <br /> STAYTON SEFTIC <br />41155 STAY'ION SCIO DR SE <br />STAYTON. 97383 <br />PHONE: 769-2302 <br /> <br />9059244 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: YES <br />SITE EVALUATION NOMBER: <br />EXISTING TANK SIZE: lO00 <br />EXISTING DRAIN FIELD LINES: <br />SERTIC:TANK PUMFED: <br />PREVIOUS NO, BEDROOMS: <br /> <br />180 <br /> <br /> Il'EH QUANTITY AMOUNT <br />ALTERATION I $280. O0 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$280.00 <br />$255.00 <br /> $0.00 <br /> <br />BALANCE DUE $25.00 <br /> <br /> PAYEE: RECEIPT NO: <br /> RECEIVED BY: CR TYPE: CHECK ~: 0 <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON'SITE SEWAGE SYSTEM, <br /> <br />FOLLOWING MUST BE COHPLETE~. IT ~S THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />AL, L NECESSARY INFORMATION HAS BEEN PROVIgEg. ' '' <br /> <br />F'LAN REVIEW: BY DATE CITY JURI. SDICTIOhl, BY DATE <br /> <br />FEMARKS; SS:RPR:MAJ:TH:READY. HOLD PEN~ING ADDITIONAL INFORMATION FROM OWNER. SEE!; LE'FTER <br /> DAl'Eb 11/2~/94. EXPIRED/CANCEL/FORFEIT 12/28/~55CR <br /> <br />OFFIC~ COPY <br /> <br /> <br />