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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 APPLICATIOH <br />D~TE/TIME 08/28/96 16=2S ACTIVITY NO : 96-~6689 <br />TYPE SP STATUS = APPLIED <br />OCCUPANCY R-3 ~E: APPLIED <br />PAGE 1 SP APPLIED : <br /> TO EXPIRE = ~2/21997 <br /> <br />WORK DESC : NJR REPAIR:TANK AND DRAINFIELD REPLACEMENT <br /> <br />EXIST BEDROOMS: 3 PROPOSED BEDROOMS : 3 <br />EXIST EMPLOYEE: PROPOSED EMPLOYEES: <br /> <br />SITE ADDRESS : CITY: AURORA 20983 FILBERT ST NE AR <br /> <br />SUBDIVISION : NFW COLONY PARK <br />CROSS STREET : OTTAWAY <br /> <br />PARCEL NUMBER : 90190-170 <br /> PARCEL SIZE : 6552.0SF <br /> <br />OWNER : BRUMELS.SCOTT DAVID <br /> ADDRESS : 20983 FILBERT NE <br /> AORORA, OR <br /> <br />PHONE : 678-1122 <br /> <br />AUTH AGENT BRUMELS,SCOTT DAVID <br /> ADDRESS ~ <br /> 20?83 FILBERT NE <br /> AURORA, OR <br /> <br /> PHONE : 6'78-1122 <br /> <br />DEQ INSTALLER : <br /> PHONE <br /> <br /> Units Description <br /> 1 Ma3or Repair <br /> 1 DEQ Surcharge <br /> <br />97002 <br /> <br />97002 <br /> <br />LOT: 1 BLOCK: 2 <br /> <br />DEQ LICENSE: <br /> <br />Fee <br /> <br /> Assessed fees : 210.00 <br /> AdjustMents : <br /> Total fees : 218.00 <br /> PAYEE: BROMELS,SCOTT DAVlB Total paxments[ <br /> Balance due . ~ 218.00 <br /> *****************************************************************--*****--WHE~E <br /> THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS <br /> SOIL~ FEASASILITY AND INSTALLATION REQUIREMENTS ~RE CHECKED PRIOR TO THE ISSUANCE <br /> OF A PERHIT. IT IS THE ~SPOHSI~ILITY OF THE APRICOT TO ASSURE THAT ALL <br /> NECESSARY IHFOR~T[ON IS PROVIDED. AS SOON AS ALL REOUIREHENTS OF THE REV[EM <br /> NAVE ~EEH HET. YOU ~ILL BE NOTIFIED. <br /> S[GN~I'ORE OF APPLICANT: <br /> <br /> *************************************************************__********* <br /> DONALD E. WOODLEY, MARION COIlIqTY BUILDING OFFICIAl_ / BY DFREILI~ <br /> <br />................ FOR OFFICE USE ONLY. THIB IS NOT A PERMIT .................. <br /> MAP: ZONE: RS PROPERTY LOCATOR~ 841WI3CA835~8 <br /> SEPTIC REVIEW: DATE: ZONING REVIEW: DATE: <br /> <br /> <br />