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 />I am performing work on a roperty I own or occupy. <br />I am a registered builder On ( ) t~e authorized representative <br />of a registered builder. <br />The work will be performed by a registered builder, <br />Other, <br />I have read end~gree to ti~e ternl$ stated on the reverse side of <br />this document. <br /> <br /> FILE <br />SIGNATURE OF A PPLICANT:~__ <br /> DATE: <br /> <br /> ..... ...... ................. I / <br /> <br />~U~LL[ <br /> OR 97325 . MARION COUNT~_ NO _~ <br /> <br /> AUMSVILLE. OR 97325 W~ 363-8747 1 Sill[ NIJNSER: 94-~B14~6 <br /> PHONE: 749-2395 VALUATION: <br /> <br />LOT: BLOCK: SECTION: TOWNSHIP: RANGE ZONE MAP <br /> <br />WROTH: ' D~"~' UNITS: <br /> , 3.88 AC ~o NO j <br /> <br />TYPEa ON--5ITE SEIJ~GE <br />PERI'lIT OR t~:'PI**ICATION NO: 9054245 <br /> <br />COHTRACTOR, NO. <br />ATKINS, ARNOLD <br />9762 BROWNELL DR SE <br />AUMSVILLE. OR 97325 3&3-87 <br />PHONE: 749-2395 <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br />EXISTING TANK SIZE: <br />EXISTING DRAIN FIELD LINES: <br /> ~UMPED: <br /> EDROOMS: <br /> <br /> ITEM <br />SITE EVALUATION, <br /> <br />PAYEE: ATKI~S__ARNOL <br />RECEIVED BY. PM <br /> <br />SEE ATTACHED DOCUMEN1 <br /> <br />QUANTITY <br /> 1 <br /> <br />ES <br /> <br />AMOUNT <br /> $265.88 <br /> <br />$265.88 <br />$265.88 <br /> <br />$8.88 <br /> <br /> RECEIPT NO: 56714 <br />TYPE: CK CHECK t: 8271 <br /> <br />SYSTEM. <br /> <br />NOTE: THIS DOES NOT <br />ONSTRUCTION PERMITS <br /> <br /> PLAN REVIEW: BY <br /> <br /> REMARKS: SE TH:READ <br /> <br /> THIS PARCEL. PLANNING AND <br />EPTIC INSTALLATION BEGINS. <br /> <br />BY ............DATE ............ <br /> <br />~.~ ~-v. ~ OF FICE COPY <br /> <br /> <br />