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MARION COUNTY BUILDING INSPECTION <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: (503) 373-4427 <br /> <br /> ON-SITE APPLICATION <br />DATE/TIME : 87/85/96 18:38 ACTIVITY NO : 96-84987 <br />TYPE : SP STATUS : APPLIED <br />OCCUPANCY : R-3 SE APPLIED <br />PAGE : I SP APPLIED : <br /> TO EXPIRE : 81/81997 <br /> <br />WORK DESC : ALTERA'rlON FOR HARDSHIP MD <br /> <br />EX[ST BEt)ROOHS: ~t PROPOSED BEDROOMS : 2 <br />KXIST EHPLOYEE: PROPOSED EMPLOYEES: <br /> <br />SiTE ADORESS : CITY: MARION COUNTY <br /> ~7~;4 SHAW SQ SE AH <br /> <br />LO'F: BLOCK: <br /> <br />CROSS STREFT : SILVERFALLS HWY <br /> <br />PARCEL.. NUMBER : 75S00-970 <br /> PARCEL SIZE' : 5.0AC <br /> <br />UWHER <br /> NAME <br /> ADDRES,. <br /> <br /> PHONE <br /> <br />APPLIf;ANT <br /> NAME <br /> ADDRESS <br /> <br />FLOWERS, JERRY <br />87i4 SHAW SQUARE RD SE <br />AUHSVILLE <br />OR 9'7~25 <br /> <br /> : f L OW~. RS... ,IERRY <br /> : 8714 SHAW SQUARE RD SE <br /> AUHSVtLt. E <br /> OR <br /> P H 0 t,li.:.' : 585-59;~7 <br /> <br />!BED CONTRAC"i'OR: F'LI]WERS~.IERR¥ <br /> / AGENT : FLOWERS~,/ERRY <br /> PHI]HE : <br /> <br />977;75 <br /> <br />DEQ LICENSE: <br /> OCC]~: 0070085 <br /> <br />!.J n_:iz~:.!:..,. ...... I?_e_.s_&,../~i..~ t i oo ........................................... i"e e <br />t A 1 '!:'e r a t i rn ............................................ <br />.l I)E[,~ Surch,'~rge ;~0. <br /> <br /> Assessed fees : 378. ~_~L__~ <br /> Adjustments <br /> <br /> , , Balance due : , <br />***************************************************************************__--**__**** <br /> <br />ISIS NOT A PE~IT TWIS APPLICATION ~UST ~ ~ROU~W A ~E~IEW PROCESS WHERE <br /> IL, FEASABILITT AN~ INSTALL~N REQUIREMENTS ~E~HEC~RIOR TO THE ISSUANCE <br />OF A PERHIT. IT IS THE RE~IBILITY OF ~AP~TO ASSURE THAT ALL <br />NECESSARY IHFORHATIOH IS~DED. AS ~~ REOUIREHEHTS OF THE REVIE~ <br /> <br />~I(?A'FtJRE OF' APF'LIC ............... <br /> <br />MAP: 51 : AR PROPERTY LO~TOR: g82W14D $11~8 <br /> <br />SEPTIC REVIEW: OATE: ZONING REVIEW: DATE: <br /> <br /> <br />