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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M, <br /> <br /> I am performing work on a property I owt3 or occupy, <br /> I am a registered builder OR ( ) the 8uthorized representative <br /> of a registered builder, <br /> The work will be gedormed by a registered builder. <br /> Other .... <br /> I have read and agree to the terms stated on Nle reverse side of <br /> this document. <br /> <br />0ATE: 01/18/90 TIME; 8:17~25 <br /> OWNER: <br /> VLAKYDA, WILLIAM <br /> <br />DATE; <br /> <br />1200 <br /> <br />CATEGORY: <br /> RESIDENTIAL <br />OCCUPANCY: <br /> <br />678 HAMPDEN LANE NE ~0NI"RAOTCITY: 'UGB: <br />SALEM OR 97305 <br /> MARION COUNTY NO <br /> gsE OF B~ILDING: <br /> <br />680 HAMPDEN LANE NE <br />SALEM OR 97305 WK ~373-3915 <br />PHONE: 362-5293 <br /> <br />100 650 <br /> <br /> SITE NUD't3ER= 9228 <br /> VALUATION: <br /> <br /> 28 , 7S 2w AR <br />AREA: UN~Ts: IRREG. LOT~ CORNER: <br /> 65000, SF NO NO <br /> <br />MAP: <br /> <br /> 41 <br /> <br />TYPE: ON-SITE SEWAGE <br /> <br />PERMIT OR APPLICATION NO: 9021217 <br /> <br />CONTRACTOR, NO. <br />VLAKYDA, WILLIAM <br />680 HAMPDEN LANE NE <br />SALEM OR 97205 WK ~373-3915 <br />PHONE: 382-5293 <br /> <br />WATER SUPPLY:PW; <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br />SEPTIC TANK PUMPED; <br />PREVIOUS NO. BEDROOMS: <br /> <br />TOTAL ASSESSED FEES ,$175.00 <br />PREVIOUS RECEIPTS $O. 00 <br />THIS RECEIPT $175.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />__~..¢'~--,"PAYEE:~ RECEIPT NO: 22622 <br /> VLAKYDA, WILLIAM TYPE~ OK CHECK ~: 488 <br /> __ ........................ <br />SEE ATTACHED DOCUMENT FOR REI:~UIRF_.MENTS OF ON-SITE SEWAGE SYSTEM. <br /> <br />NOTE= THIS BOBS NOT GRANT O~ I)4PLy =PE~I~ION TO BUILD lliIS PARCEL. PLANNING AND <br /> <br />PLAN REVIEW*. BY_~____ OATE_J~'")-~-''Ot,'~) CITY JURISDICTION: 87 DATE ......... <br />REMARKS: PARCEL 2 <br /> <br />F()HM" MC'; lb SU ~i-V S/~ OFFICE COPY <br /> <br /> <br />