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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER ~:~ <br /> <br />DATE/TIME : 84/11/96 15:44 <br />TYPE : SP <br />OCCUPANCY : <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Houm: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 588-7904 <br /> <br /> ON-SITE APPLICATION <br /> ACTIVITY NO : ?6-82466 <br /> STATUS : APPLIED <br /> APPLIED <br /> TO EXPIRE : 18/88/1976 <br /> PAGE I <br /> <br />F:X]'ST EMPLOYEE: FROFO,~ED EMFL( '~EES: <br /> <br />SITE At)ORFSS : CITY: MARION COUN'FY .1.1,.,.,.~ MCCLELLAN LN SE AM <br /> <br /> SliBO'[VTS'ION : <br /> <br />CROSS S'TRFET : MAPLE ST' <br /> <br />PARCEL NUMBER : 75440-090 <br /> PARCEL SIZE : 1'588~, 8SF <br /> <br /> OWNFR <br /> NAME : MO~?O~ERY,SHEII..A <br /> ADDRF;RS : 11555 MCCI.EI..I..AN <br /> AIlHSVI[ LE~ OR <br /> <br /> AF'F'I.. 1CAFtT <br /> NAME : MONT~OMFRY~SHEILA <br /> ADORESS : 1 lo,.,,.~ MCCL J...LAN <br /> <br />OEO CONTRACTOR: MOIqT~OMERY~ SHEIL. A <br /> : MON'rGOHERY~ SHE'ILA <br /> <br />97~25 <br /> <br />LOT: BLOCK: <br /> <br />DEQ LICENseE. <br /> OCCB: <br /> <br /> Assessed fees : 247.00 <br /> AdjustMents : .00 <br /> Total fees : 247.00 <br />F'AYF'F: MONT~OMERY~SHEILA Tota] pay~,~ent's: 247.00 <br /> , Balance due .' , .00 <br />********************************************************************************** <br /> <br />THIS IS HOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE <br />SOIL~ FEASABILITY AND INSTALLATIOH REQUIREMENTS ARE CHECKED PRIOR TO THE ISSUANCE <br />OF A PERMIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL <br />NECESSARY INFORMATIOH IS PROVIDED. AS SOOH AS ALL REOUIREMENTS OF THE REVIEW <br />HAVE ~EEH HET~ YOU WILL ~E HOTIFIED. <br /> <br />SIGNATURE OF APPLICANT: <br />*********************************************************************************** <br /> WOODLEY~ MARION COUNTY B~I*'I.,DIN{; OFFICIAL / BY ~'~ <br />I)(INA} D <br /> <br /> -FOR OFFICE USE ONLY. THIS IS NOT A PERMIT, <br />MAP: ZONE: AR PROPERTY LOCATOR: O~2W13DA02300 <br /> <br />SEPTIC REVIEW: DATE: ZONING REVIEW: DATE: <br /> <br /> <br />