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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 8:00 - 4:30 <br />'24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing WOrK on eproperty ~ own or occupy. <br />I em a registered builder OR the authorized representative <br />of a registered builder. <br />The work ~ill be ~)erformed by a rag stared builder <br />Other <br />have reea aha agree to the terms stated on the reverse side of <br />this document, <br /> <br />SFrU~,,ADDRE$S: I CONSTRUCTION TYPE: , OCCUPANCY: <br /> ATKINS, ARNOLD 56104-001 RESIDENTIAL <br /> <br />OR 97325 <br /> <br />~~'?Y72 BROWNE1Z~-I)R <br /> AUMSVtLLE <br /> <br />MAILING ADDRESS: <br /> <br />l-CONTRACT CITY: I T~-~'~fi~L6A~ ...... <br /> MARION COUNTY NO <br /> <br /> ?762 BROWNELL OR SE <br /> <br />LOT. PHON -23~5 ' OWNSHiP: <br /> <br /> IRREG. LOT: -1 CORNER: <br />L--1W ......... L_AR. <br /> <br />\ 3.88 AC <br /> <br />TYPE: ON-SITE SE#&GE <br /> <br />PF.I~IT OR ~PPLIC~TION <br /> <br />CONTRACTOR, HO. <br />ATKINS. ARNOLD <br />?762 BROWHELL DR SE <br />AUMSVILLE. OR 97325 <br />PHONE: 749-2395 <br /> <br />54245 <br /> <br />NO NO <br /> <br />WATER SUPPLY: PW <br />TEST HOLES READY: <br />SITE EVALUATION NUMBER: <br /> ;IZE: <br />EXISTING 'IELD LINES: <br />SEPTIC TANK <br />PREVIOUS NO. <br /> <br />ITEM QUANTITY AMOUNT <br /> 1 $265.08 <br /> <br />:S <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: PB TYPE: CHECK <br /> <br />SEE ATTACHED DOCUMENT <br /> <br />;YSTEM. <br /> <br />$265.80 <br />$2&5.00 <br /> $8.88 <br /> <br />$0.08 <br /> <br />0 <br /> <br />NOTE: 1HIS I)OES NOT GRANT OR IMPLY PERMISSION TO BUILD ON THIS PARCEL. PLANNING hflB <br />[INS[RUCTION PERMITS MU.~ ~~~TIC INSTALLATION BEGINS. <br /> <br /> REMARKs.. SE MARGINAl~, FOR STA~IDARB WITH UPSLO~E CURTAIN BRA.N. RECOMMENd) A F~ELD <br /> _ ~1AKEOIJ ~ P~IOR ~ :~~~ <br /> ;DONALD E, WOOI)LEY~ MAR~X1N COUNTY~BUILDING OFFICIAL / BY <br /> <br />~.~ OFFICE COPY <br /> <br /> <br />