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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 />DH-SITE APPLICATION <br /> <br />DATE/TIHE <br />TYPE <br />OCCUPN'ICY <br />PAGE <br /> <br />: O9/12/96 1B:16 ACTIVITY NO : 96-87185 <br />: SP STATUS : APPLIED <br />= R-3 SE APPLIED : <br />: ! SP APPLIED = <br /> TO EXPIRE : 83/11997 <br /> <br />WORK DESC : AUTH:FLD <br /> <br />EXIST BEDROOMS: ~ <br />EXIST EMPLOYEE: <br /> <br />SITE ADDRESS : <br /> <br /> ADDING BEDROOH TA RESIDENCE <br /> <br />PROPOSED BEDROOMS : 4 <br />PROPOSED EMPLOYEES: <br /> <br />22555 BENTS RD NE AR <br /> <br />CITY: MARION COUNTY <br /> <br />SUBDIVISION <br /> <br />LOT: BLOCK: <br /> <br />CROSS STREE'F : EHLEN RD <br /> <br />PARCEL NUMBER : 73060-818 <br /> PARCEL SIZE : 92400.8SF <br /> <br />OWNER : D~YDEH~DAVID M <br /> ADDRESS : 22555 BENTS RD NE <br /> AURORA, OR <br /> <br />PHONE : 678-2568 <br /> <br />97882 <br /> <br />AUTH AGENT <br /> ADDRESS <br /> <br />: SCHOMUS THOMAS CYRIL <br />: 21818 BOONES FERRY RD NE <br /> <br /> AURORA, OR 97802 <br />PHONE : 888-8080 <br /> <br />DEE INSTALLER : <br /> <br />DED LICENSE: <br /> <br />PHONE : <br /> <br />Units Desc:r ip'~i~on - , <br />I -Au~,-~orization w/Fi-~[d Vis~.~ <br />i DEQ Surcharge <br /> <br />Fee <br /> 217~00 <br /> 30.80 <br /> <br /> Assessed fees 247.80 <br /> Ad just~mnts .08 <br /> Total fees 247.00 <br /> PAYEF: SCHOMUS THOHAS CYRIL Total pay~ents: 247.80 <br /> Balance due : <br /> ********************************************************************************** <br /> <br /> THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE <br /> SOIL~ FEASARILITY AND INSTALLATIOH REQUIREHENTS ~E CHE~.KED PRIOR TO THE ISSUANCE <br /> OF A PERMIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL <br /> NECESSARY INFORHATION IS PROVIDED. AS SOON AS AL~ RE~I(JIREMENTS OF THE REVIEW <br /> HAVE BEEN HET, Y~J WILL ~N[II'IFIEO. . ~ // <br /> <br /> *****************************************----********************************** <br /> DONALD E. WOODLEY, MARION COUNTY BUII._DIN~ OFFICIAl. / BY DFREILIN <br /> <br />................ FUR OFFICE USE ONLY. THIS IS NOT A PERMIT .................. <br /> NA~ 4 ZONE: EFU PROPERTY LO~ATOR: 841W84D 01488 <br /> <br />SEPTIC REVIEW: DATE: ZONING REVIEW: DATE: <br /> <br /> <br />