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MARION couNI~~ BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE. Room 132 * Salem, Oregon 97301-3670 <br />Off[ce Hours: 8:(]6.4:30 * Phor~ei i503) 588-5147 · 24-HR Inspection Line: (503) 588-7904 <br /> <br /> OH-SITE ~PPt. ICATIB~ <br />DATE/TINE 11/~8/95 08:47 ACTIVITY NO : 95-17~45 <br />TYPE SP STATUS = APPLIED <br />OCCUPANCY R-3 APPLIED : 11/08/1995 <br /> TO EXPIRE <br /> <br />WORK DFSC := ALl'IH/MD PLACENFIqT <br /> <br />EXIST BEOROOMS: 2 PROPOSED BEDROOMS : ~ <br />EX~ST EHPL. OYFE: PROPOSED E~PLOYEES: <br /> <br /> S"[TE A~RESS ; C~TYt ~ARISN C~UNTY <br /> 14~[8 I(F~L. RD NE AR <br /> <br />$1J~D~V~S~OI,I : LOT= GI..OCK~ <br /> <br />CROSS STREET : <br /> <br />HUBBARD CUI'OFF <br /> <br />PARCEL NIJM~ER : 40~86-000 <br /> PARCEL SIZ~ : 1,1 AC <br /> <br />NAME; ~ DAWSON.JOLLY <br /> AURORA OR <br /> <br />PHONE' : 297-4334 <br /> <br />APPLICANT <br />NAME : DAWSON.JOlLY <br />AODRE~S : 14~18 KEIL RD NE <br /> AURORA OR <br /> <br />PHONE' : 297-4334 <br /> <br />97~2 <br /> <br />77~2 <br /> <br />DEQ CONTRACTOR: DAW~ObI~JOLLY <br /> / A[;FNT : DAWSON.JOLLY <br /> PHONE : 297-4334 <br /> <br />DEQ Surcharge <br /> <br />DES LICENSE: <br /> <br />Fe~_,, <br /> <br /> 30.00 <br /> <br />PAYEE. DAWSON~JOLLY <br /> <br />THIS IS HOT A PERHI¥. THIS APPLICATION <br />SOZL, FEASABIL~TY AND ~NSTALLATION <br />OF A PERHZT. IT IS THE RESPONSIBILITY OF <br />NECESSARY ~NFDRHAT~OH IS PROVIDED. <br />HAVE BEEH HET~ Y~ ~LL <br /> <br />~GIqA'('URE OF APPLICANT: <br /> <br />~tMent~ : <br />~al fees : 247.08 <br />~al pexments: 247.88 <br />l~nce due : .08 <br /> <br />Js~ Go ll4R~OUGH A EEVIEU PROCESS WHERE <br />~ENTS ARE CHECKED PRIOR TO THE ISSUANCE <br />~HEAPI~LICAHT TO ASSURE THAT ALL <br />IH AS ALL REQUIREHEHTS OF THE REVIEW <br /> <br /> DONA~O [:'. W(/I(:IDt.,EY~ MARION COLINTY BIIII..DINGiO'FICIA. / BY HBULL <br />................ FOE OFEICE BSE ONLY. THIS IS N~T A PERNIT <br /> ~AP: $ ZONE: EFU PROPER~Y LOCATOR: e41WllD <br /> SEPTIC REVIEW: DATE: zoNiNG REVIEW: ~ATE: <br /> <br /> <br />