Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />· 220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 888-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />registered builder. <br /> <br />' °WNE~ATE: <br /> <br />' S~TUS i~m"~:~Ss~'RAIqClS A ~ <br /> <br />IAL.. <br /> <br /> 10755 MIX RD SE <br /> AUMSV.tLLE OR._.SZ325 MARION~ C9.UN;IY._ BO <br />u~E OF BUILDING: <br /> <br />SAME <br /> SITE NUMBER: 94-040?7 <br />PHONE: 747-1~54 VALUATION: <br /> <br />TYPE: ON-SZTE ~E~AGE <br /> <br />CONT~A~TOR~ NO. <br />MIX, FRANCIS A. <br />SAME <br /> <br />PHONE: 747-1~4 <br /> <br />9059068 <br /> <br />WATER SUPPLY <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPEB: <br />PREVIOUS NO. BEDROOMS: <br /> <br /> ITEM QUANTITY MOUNT <br /> ANNUAL EVAL. - TEMP OR HDSHP MH 1 $125.00 <br /> <br /> TOTAL ASSESSEB FEES $12§.00 <br /> PREVIOUS RECEIPTS $90. O0 <br /> THIS RECEIPT $0. O0 <br /> <br /> BALANCE DUE $35.. 00 <br /> PAYEE: RECEIPT NO: <br /> RECEIVEI) BY: CE TYPE: CHECK #: <br /> SEE ATTACHED DOCUMENT FOR REQUIREMENTS OF ON-SITE, SEWAGE SYSTEM. <br /> <br /> 3 THIS IS NOT A PERMIT. THIS APPLICATION M~ST GO THROUGH A REVIEW PROCESS W E THE <br />FOLL, OWING MUST BE COMPLETE~, IT tS THE RESPONSIBILITY OF THE APPLICANT TO AS E THAT <br />ALI, NECESSARY INFORHATION HAS ~EEN PROVIBED. ' <br /> <br />PLAN REVIEW: BY DATE CITY JURISDICTION: BY <br />RE,ARKS: HDSP/ TANK NOT PUMPED. LT MAI'LEB ~0/17/~4~ CAL. L. ED MR MIX 1/~0/95. <br /> CANCELED/FORFEIT 12/28/95,OR <br /> <br />2~ <br /> <br />EXPTRED APP <br /> <br /> OFFICE COPY <br />FORM # MC 15-~6 REV, 4/s90 <br /> <br /> <br />