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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br />DATE/TIME ~ t~/26/95 <br />TYPE : SD <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Photte: (503) 588-5147 · 24-HR inspection Line: (503) 588-7904 <br /> <br />15:54 <br /> <br />S£P~IC PERMIT <br /> <br />PEIG4IT XO : 95-18~72 <br />STATUS : ISSUED <br />ISSUED = 12/26/1995 <br />TO EXPIRE : 12/28/19~6 <br />PAGE I <br /> <br />CROSS STREET <br /> <br />PARCFL NtlHBER <br />PARCEL SIZE <br /> <br />OWNER NAMF <br /> <br />APPLICANT <br /> N~M~ ~,, <br /> A~DRE,~S <br /> <br />SANTIAM AV <br /> <br />LOT.'. BL061(: <br /> <br />.3 AC <br /> <br />PROPERTY LOCATOR: 10oE.~lC, B~97~O <br /> ZONE: RS <br /> <br />SHAFFER,MICKEY D & SANDRA D <br /> <br />SHAFFER.MICKEY D & SANDRA D <br />'£2tB ~RD AVE <br />STAYTON~ OR <br /> ~7~8~ <br /> <br /> PHONF : <br /> <br />F;ONTRACTOR/ : KEV'I;N'~ BACKHOF SERVICE <br /> A6FNT <br /> <br /> PHONE .' (50~) 854-~797 <br /> <br />~N~T.TAL SYSTEM: STANDARD <br />REPLACEMENT SY~l'~: <br /> <br /> 1 DFQ Surcharge <br /> <br />D~Q I..1~ ,EI'ISE.:3&421, <br />OCI.,B. <br /> <br />30.00 <br /> <br /> Assessed 'fees ~78.00 <br /> Ad:~s~Me~s .00 <br /> Tot81 fees . ~78,, 00 <br /> To:t~ p~X~m~ts. ~78.00 <br /> PAYEE: SHAFF'ER~M~CKEY D & SANDRA D Bm:l~nce due : .00 <br /> <br />THIS PERMIT IS ~ON-TR/¥~SFgRADLE ARD EXPIRES 385 DAYS FROM IBSUE DATE tF WORK NAS NOT <br />COHNENcE9 OR IF WORK FAILS TO NEET ALL :REaUiREHENTS OF STATE LAWS AND HARION COUNTY <br /> <br /> DONALD E WOODI. EY~ ~AR:[ON COUNTY BU'~LDING oFFiCIAL / BY TNEAL <br /> <br /> <br />