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MARION COUN'FY BUILDING INSPECTION <br />COMMUNI'FY 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) 588~7904 <br /> <br /> BUILDINg APPLtCATT~ <br />DATF/r !~E <br /> <br />OECSP~NCY : ~-1 TO EXPIRE ~4/17/1~9& <br /> <br />WORK DKBC ~ P(');,E BUIL'OiN~; FOR PERSONAL STORagE/SHOP <br />SiTE ~I~DRESS <br /> <br />{.,,lo.),)S [FTIREET : S f~¥TOll RD SE <br />PAP, CEL NUMBER : ~=~o ........ <br /> <br />D~NI,.',.'R MA~I{ : &RI~IE'R.~DA¥ID L}SRDY <br /> <br />A P I:' L I C A N 'T <br /> <br /> ADDRiE~8 <br /> <br />PHP, N~ <br /> <br />PHONE <br /> <br />F'RUETT DOUGLA,c]N <br />12023 W STAYTON RD <br /> <br />AUMSV I LI...E,~ OR <br /> <br />HEIC, HI': 16 <br /> <br />................................................................................................ T~'~'?'O~' <br /> $%20 <br /> <br /> As!~essr,qJ 'Fees <br /> Ad jus'l;ments <br /> Total fees <br /> Total pSXPl(~f)'['~5~ ...... <br />F'AYEI{~ PRUE'TT DOUGLAS N B~lanc~ Liu[~ <br /> <br />THIS IS NOT A PERMIT. THIS APPLICATIQN MUST GO THROUGH A SIMULTANEOUS REVIEW PROCESS <br />WHERE ZOMING~ SEPTIC (IF APPLICABLE) AND CONSTEU~ION PLANS ARE CHECKED PRIOR TO THE <br />ISSUANCE OF A PERMIT. IT IS THE RESFON~ITY ~ THE AFPL~CANT TO ASSURE THAT AL.L <br /> <br />:3tf;~,~AI'URF OF APPLICANT: .L .... ~.._~ ........... <br /> <br />q(',;,,A' ~ E',. ~4(]ODL.EY~ MARION COUNTY <br /> <br />.......................................................................... FOR OFFICE USE ONLY <br /> <br />l)ATIfi". /r, '4 {}/ <br /> <br /> <br />