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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br />DATE/TTHE <br />TYPE: <br />OCCUPAIIICY <br /> <br />SEPTIC PERH~T <br /> <br />= il5/22/96 15=45 PERHIT HO : 96-128~7 <br />: SP STATUS : ISSUED <br />= R-3 ISSUED : <br /> TO EXPTRE -' ~5/22/19~7 <br /> PAGE <br /> <br />Wi]RK DFSC <br /> <br />SITE ADDRESS <br /> <br />: AIT;A~OND OLD INSTALL NEW-NOT FAILIN~ <br /> <br />: CITY: MARION COUNTY <br /> 8973 SHAW SQUARE SE AM <br /> <br />SUBDZVISION : <br /> <br />LOT: BLOCK: <br /> <br />CROSS STREET : SILVER FALLS HY <br /> <br />PARCEl_ NUMBER : 75300-361 <br /> PARCEl SIZE : 1.4AC <br /> <br />PROPERTY LOCATOR: 082W13C 05401 <br /> ZONE: AR <br /> <br />OWNER NAME : AMSBERRY, VELONI B <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br />: CA CONSTRUCTION <br />: 5]8 VALLEYWOOD DR SE <br /> SALEM, OR <br /> <br />PHONE : 363-1711 <br /> <br />97306 <br /> <br />6~RNTRACTOR/ : DEQ LICENSE: <br /> AGENT : OCCB: 0098940 <br /> <br />PHONE : 769-7744 <br /> <br />~NIT~AL SYSTEM: <br />REPLACEMENT SYSTEM: STANDARD <br /> <br />Units Description Fee <br />T Aztera'~Jofi' 348. B0 <br />1 OEO Surcharge 38.88 <br /> <br /> Assessed fees : 378.00 <br /> Adjustments : .00 <br /> Total fees : 378.00 <br /> Total pe%ments: 378.00 <br /> PAYEE: CA CONSTRUCTION Balance ~ue : .00 <br /> <br />T~I~ PERHIT I~ I, IOI,I-TR&I,I~FE~/~'LE ~ EXPII~8 ~&5 1~¥8 FROH I~E I~TE IF WOI~ HA~ HOT <br />COI'II'JE~O OR IF ~ F~IL~ TO ~EET ~LL J~J~JIREI~I'II'~ OF STATE LAI~ AI,I~ HARION COUNTY <br />ORDINANCES. <br /> <br /> ~T~NATURE OF APPLICANT: <br /> <br /> DBNflLO E WOO~LEY, MARION COUNTY ~U~L~IN~ OFFICIAL, / BY OFREILIN~-" <br /> <br /> <br />