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MARION COUN'FY BUILDING INSPECTION <br /> <br />COMMUNITY 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: (553) 588-7904 <br /> <br /> ON-SITE APPLICATIOH <br />I)ATE/T![NE : 11/8~/~5 15=48 ACTIVITY NO : ~5-17521 <br />TYPE : SP STATUS : RPPLIE~ <br />OCCUPANCY = R-~ APPLZE~ : 11/~/1~5 <br /> TO EXPZRE : ~5/87/1~ <br /> <br />~0RK DFSC ~ S~ H]N0~ ~FPA]~ <br /> <br />EX.f. ST ~EO~OOH~: 3 ~ PROPOSED BEDROOMS : <br />EXIS'I FHPt OYEE: PROPOSE]) EMPLOYEE~: <br /> <br />SITE ADDRESS : CITY: MARION COUNTY g~6~7 HI(;HWAY 99E NE AR <br /> <br />SUBDIVISION : LOT~ BLOCK: <br />CROS~ STREET : SOHTH OF OTTOWAY R~ <br /> <br />PARCEl_ NUM~EE : 4~497-~ <br /> PARCEl SIT~ : 1.~ AC <br /> <br />OWNER <br />NAME : ME~KERS~MA~T~N W & HEL. ENE,C <br />ADDRESS : PO BOX ~11 <br /> AURORA~ OR <br /> 97882-~9~ <br />PHONF : <br /> <br />APPLICANT <br />NAME : KUNZMAN EXCAVATIN~ <br />ADDRESS : 25868 hie ~LASS RD <br /> AURORA~ OR 97882-999 <br />PHONE = 678-1447 <br /> <br />DEQ ~OHTRAC'I'OR: KUNZHAN EXCAVATIN~ INC ~Eg LICENSE: <br /> / AGENT : KUNZMAH EXCAVATING INC OCCB: <br /> PHONE : 678-1447 <br /> <br /> Ur~i~'s 'Oesc r' ;~io~ Fee <br /> -~-- ~r ~epa~r ....................... ~' <br /> 1 ~EQ ~urcharge ~0. <br /> <br /> PAYEE: KUNZflAN EXCAVATIN~ IHC <br /> <br /> THI~ IS HO/ A PERHIT. TH~S APPLIC~TIOH HI IST GO ~ROUGH ~ REVIEW PROCESS WHERE <br /> SOIL, FEASAB/LITY AH~ ~NSTALL~TIOH~REQU~REHENTS ~E CHECKED PEI0E T0 THE ISSUANCE <br /> OF A PERHIT. IT [S THE RESPONSIB~E[TY OF~THE AP~ICAHT TO ASSURE THAT ALL <br /> NECE~ARY IflFGRHATIOH IS PROV[DED.: AS ~N AS ~L.REgUIRENEHT~ OF THE REVIE~ <br /> S~;NATIJR~ OF APPLICAMT: ~~~ ~ <br /> <br /> ................ FOR OFFIC[ US~ ONLY. TH~B ~S HOT A PERHIT ......... ~-~ ...... <br /> HAP~ ~ ZONE: EFU PROPERTY LOCATOR: 841W1~C <br /> SEPTIC REVIEW: ~ATE: ZOHIH[ REVIEW: ~ATE: <br /> <br />;sessed fees 1~8.00 <br /> <br />~tal fees 130.00 <br />)tel payments: 130.00 <br />~lmnce ~ue : .00 <br />******************************************* <br /> <br /> <br />