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MARION COUNTY BUILDING INSPECTION
<br />' ' COMMUNI'rY DEVELOPMENT CENTER
<br />
<br />DATE/TIME
<br />TYPE
<br />OCCUPANCY
<br />
<br /> 285 Church St~st NE · Room 132 * Salem~ Oregon 97301-36'/0
<br /> Office Hours: 8;00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 588-7904
<br />
<br /> OH-SiTE APPLICATION
<br />11/29/95 09:22 ACTIVITY Ho 95-I778~
<br />
<br />R-3 APPLIED
<br /> TO EXPIRE
<br /> PA~E
<br />
<br />PROPOSED BF-'I)ROOMS : 2
<br />~ ~ .Ir ,-Sr.[) E, MPL]YEI,.,..~i--
<br />
<br />'l;'~ F'RI]NI' ,,S"f' DT
<br />
<br />CITY: DE'I'F~OT! 'f
<br />
<br />· ,,I D,bI,,~I JIt ,, HAM~(Hq)} ADD
<br />
<br />I ¢m,f,E,l,, I, UMFJ:'R : 90221,-,490
<br /> PAF(CI{L. ~)IZI::, : .6 AC
<br />
<br />NAME ::
<br />AI)DRE$S :
<br />
<br />:
<br />
<br />Al. } L, IBANf
<br /> A):)DRE'~S
<br />
<br />WINTERBERGER, FRANK A & I~EI'TY Lr}u
<br />1359~SE :I, 48TH
<br />J::'OI'~'I],,AIqD~ BR
<br /> 973~2
<br />
<br />PEDERSEN,~ ERLAND
<br />19'75 MADI,~OI,IA AV S
<br />SALEM '"
<br />
<br />F'HI:)N E ,'; ,J 8,,~-407a
<br />
<br />97302
<br />
<br />Dti:,Q r_ {])11 RAL, } 01% K[,,'V]I¢~ S BACKHOE' SERVIOE DEB L 1
<br /> / A~J[I~JT ,~ PEI)ERS,F;'?}~ ERLAH'r)
<br /> FHONE : (50~s) 8=;4-3797
<br />
<br /> :1. DEQ Surcharge :,"
<br />
<br /> E
<br /> Assessed fees :
<br /> Adjustments : ,,
<br />
<br /> T~tal oe~ments:
<br />
<br /> TH~S IS N~T A PERMIT. THIS ~PPLI~TION MUST ~0 THROUGH A REVIE~ PROCESS ~HERE
<br /> SOIL~ FERSAgILITY AND INSTALLATION REOUIEEHEHTS ~E CHECKED PRIOR TO THE I~URNCE
<br /> DF R PERHIT. ~T IS THE RESPONSIBILITY OE~THE ~P~ICAHT TO ASSURE THaT ~LL
<br />
<br /> HAVE BEEfl HET, YOU ~ILL BE NOTIFIED. u:
<br /> S.~:{;NAFURE OF ~IDPL,,ZC~NT= ] ~
<br />
<br /> DOHAf..D E,, WOODI,_EY, ~ARiON [XIUI4TY BUILDINGi,OFF:[CZAL / t~Y Ti,lEAL
<br /> h !
<br />................. FOR OFFICE USE ONLY.' THIS ~S NOT A PERMIT
<br /> MAP: lB5 ZONE: RS PROPERTY LOCATOR.~ I~SEglBCl6~O~
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<br /> SEPTIC REVIEW: DATE: Z~HIHG REVIEW: DATE:
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