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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 />DATE/TItlE <br />TYPE <br />OCCUP,4~iICY <br />PACE <br /> <br />: <br />= SP <br />= R-3 <br />: I <br /> <br />18:82 <br /> <br />ON-SITE APPLICATION <br /> <br />~CTIVITY NO <br />STATUS : APPLIED <br />SE APPLIED <br />SP APPLIED : <br />TO EXPIRE : 81/81997 <br /> <br />WORK DES[; <br /> <br />: SS:AUTH/ALTR REPL.: 2BEDRM W/3BEDRM <br /> <br />EXIST BEDROOMS: 2 <br />EXIST EMPLOYEE: <br /> <br />PROPOSED BEDROOMS : <br />PROPOSED EMPLOYEES: <br /> <br />SITE ADDRESS : <br /> <br />9205 BATES RD SE AM <br /> <br />CITY: MARION COUNTY <br /> <br />SUBDIVISION : <br /> <br />CROSS STREET : WEST STAYTON <br /> <br />F'ARCEL NUMBER : 58295-000 <br /> <br /> PARCEL SIZE <br /> <br />OWNER <br /> NAME <br /> ADORESS <br /> <br /> PHONE <br /> <br />APPLICANT <br />NAME <br />-~ADDRESS <br /> <br />F'HONE : <br /> <br />: 3.0AC <br /> <br />JURICICH, JEAN E <br />9205 BATES RD <br />AUMSVILLE, OR <br /> <br />: JURICICH, JEAN E <br />: 9205 BATES RD <br /> AUMSVILLE, OR <br /> <br />DEQ CONTRACTOR: JURICICH, JEAN E <br /> / AGENT : JURICICH, JEAN E <br /> PHONE : <br /> <br />97325 <br /> <br />97325 <br /> <br />LOT: <br /> <br />BLOCK: <br /> <br />DEL1 LICENSE: <br /> OCCB: <br /> <br />Units Descripti~! , Fee <br />1 AuthorizatiC~d'w?Field Visit 217,0~ <br />1 Authorization/Alteration 131.00 <br />1 DEQ Surchar§e 38.88 <br /> <br /> Assessed fees : 378.80 <br /> AdjustMents : .00 <br /> Total fees : 378.80 <br />PAYEE: JURICICH, JEAN E Total paxMents: 378.08 <br /> Balahce ~ue : .00 <br /> <br />THIS IS NOT A PERMIT. THIS APPLICATION NUST CO THROUGH A REVIEW PROCESS WHERE <br />SOIL, FEASABILITY AND INSTALLATION REOUIREHENTS ARE CHECKED PRIOR TO THE ISSUANCE <br />OF A PERMIT. IT IS THE RESPONSIBILITY_~_.[LF THE APPLICANT TO ASSURE THAT ALL <br />NECESSARY INFORMATION IS PROVIDED..,--'/~S SOON AS ALL REQUIREMENTS OF THE REVIEW <br />HAVE BEEN MET, YOU WILL BE NOTIFI4~D. / / ,~ ~ <br /> <br />DONALD E. WOODLEY, MARION COU BUILDING OFFICIAL / BY CLYNCH <br /> FOR OFFICE USE ONLY. THIS IS NOT A PERMIT- <br />MAP: 52R ZONE: AR PROPERTY LOCATOR: 882W36A 01880 <br /> <br />SEPTIC REVIEW: DATE: ZONING REVIEW: DATE: <br /> <br /> <br />