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Nov 18 18,07:59p Danielson Contractors Inc 5037622459 p.1 <br /> F • <br /> MARION COUNTY BUILDING INSPECTION DEVT., 1 s ff I s -� <br /> 7.7 5155 Silverton Rd NE J <br /> `i/ �' <br /> Salem OR 97305 <br /> (503)588-5147 NOV 2 0 2018 <br /> Fax:(503)588-7948 <br /> M' -,lUN COUNTY <br /> BUILDING INSPECTION <br /> LAND USE COMPATIBILITY STATEMENT(LUCS) <br /> FOR ON-SITE SEWAGE SYSTEMS <br /> EXPIRED <br /> DATE: 11/14/2018 MCBI File#: <br /> SECTION 1 —APPLICANT INFORMATION <br /> 1. Property Address:_137 Patton Rd S Property ID it: R98118 <br /> Section: 1 Township: 10 Range: 5 Tax Lot tt: <br /> 8600 <br /> 2. Name of Applicant: _Sonia Kellas/Dave Danielson <br /> Telephone il:_503-519-5135 Mailing Address: _5106 SE 99th <br /> Ave_Portland Oregon 97266 <br /> 3. Describe type of facility the on-site sewage system will serve(business,residence or other): <br /> 14. Single Family Residence <br /> ❑ Business <br /> ❑ Other: <br /> 4. Type of on-site sewage system permit application being proposed for this property: <br /> ❑ New Installation Permit <br /> Repair Permit <br /> ❑ Alteration Permit for: ❑ Replacement Dwelling ❑ Bedroom(s)addition <br /> Cl Other changes in land use involving potential sewage flow increase: <br /> G:\PORMSSEPIIC1Application Packels\S-39 LUCS.doc MC:S-39 rev:8/10.04/12 <br />