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 />~ ~[ read and ~¢ee to the terms stste~ on the reveme 'ida of DATE ......... <br /> <br /> ........................................................................... ~ ddduP~cv; <br /> <br /> 4 <br /> <br /> : PARCEL 2 <br /> P.O- ~OX 349 ~ ................................................................ <br />,, ~IJRORA~ O~ : SZTE ~UHB[R= 94-~2854 <br /> <br />~ ........................ ::,,:~ ............... j e~63 j AC 0 NO <br /> <br /> TYPE= ON-S~TE SE~E ~ATER ~UPPLY= ~ <br /> TEST HOLES READY: <br /> PERNIT OR APPLICATI~ ~: ~56~1 SITE EVALUATION NUHBEE: 38~B8 <br /> EXISTING TANK <br /> CONTRACTOR~ NO. EXISTING DRAIN FIEL9 <br /> HEiNIIIGE,U ~ICHAR9 & ELIZABETH SEPTIC TANK PUMPED: <br /> P.O. BOX ~4~ .. ............. PEEV[~S NO; <br /> AORO~{A,~ <br /> PHONE~ <br /> <br /> lT~ · QUANTITY AMOUNT <br /> STANQARD ON-SITE SYSTE~ ~ ;' , .... : .... <br /> :'[ ... ~ '.' ' .... -'] TOTAL ASSESSE~. FEE~ $255 <br /> <br /> :......'.-'.:::'.:.i.:. ;."", '-',.','. ,2s . <br /> RECEIVED ~Y: PH ? TYPE: ~N CH~CK ~: <br /> <br /> FOLLOW~.H~ HUST BE COHPLETED...-'~T'm ~'S'.TflE'7 RESPONSIBILITY .OF THE APPLICANT TO ASSURE TRAT <br /> ALL ME~ESSARY IHFOEMATION HA~ 'BEEH ,PEOYISE9. ' ' ' <br /> <br /> F'LAN I~EVIEW: BY ...... DATE~. '~2 ..... CITg. JURISDICTION: BY ........ DATE <br /> EEHARKS= SS: 516 SYS . ~NOTE:.~..FZLE .~92-524 UTL IH SOX-NO INFO ON FILM <br /> <br />OFF~CE COPY <br /> <br /> <br />