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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY*DEVELOPMENT CENTER <br /> <br /> ~ Ch~ch Steer NE · ~ 132 · ~alem, Oregon 97361-3670 <br />Office Hours: 8:~0-4:30 · Phmle: (503) 588.5147 · ~.HR I~$pemtlon Ll~e: (503) 373.4427 <br /> <br />DATE/TINE : ~,7,/1'2/77 14=39 ONTSZTE.APPLZCATION <br /> <br /> STATUS ~ : ~PL. ZED <br />I'¥PE ~P3 ACTIYZ~?O : 77-B1592 <br /> : 5~ APPLIED .= ~B3/le/1997 <br /> TO EXPIRE : ~9/D8/1997 <br />WORK I)ESC : AUTH-FIELD VISIT- 3/12 - OHG APP TO MAJOR REPAIR <br /> <br />EXIST BEDROBMS: 2 PROPOSED BEDROOMS : 3 <br />EXIST EMPLOYEE: PROPOSED EMPLOYEES: <br />SITE ADDRESS : CITY: MARION COUNTY <br /> 12364 WEST STAYTOfl RD SE AM <br /> <br />S[tBDIVISION : <br /> <br />CROSS STREET : STAYTON RD <br /> <br />PARCEL NUMBER : 75710-128 <br /> PARCEL SIZE : .79 AC <br /> <br />LOT: BLOCK: <br /> <br />OWNER : THOMPSON,CURTIS'D & MONA JO <br />ADDRESS : 12564 W ~TAYTON ROA~ <br /> AOHSV~LLE, OR <br /> 97385 <br />PHONE : 769-7853 <br /> <br />AUTH AGENT : <br /> ADDRESS : <br /> STAYTON OR <br /> <br />PHONE : 769-7853 <br />~E~ INSTALLER : <br />PHONE <br />Upits <br /> <br />THOMPSON, CURTIS & MONA <br />12364 W. S1AYTON RD <br /> <br /> 97385 <br /> <br />DEQ LICENSE: <br /> <br />Description <br /> '~ajor Repair <br /> Au,thOrization w/Field Visit <br /> ~EO Surcharge <br /> <br />217.00 <br />30.08 <br /> <br /> Assessed fees : 247.08 <br /> Adjustments : B~ <br /> Total fees : 247:~8~ <br /> PAYEE: THOMPSON, CIJRTES & MONA 'Total pmxments: 247. <br /> Balance ~ue - .00 <br /> ********************************************************************************** <br /> ~ I~_~H~_~_~[~H~X~ ~HIS ~ICATION ~i GO THi~OU;H ARE¥IEW ~ESS WHE~ <br /> O~ ~''~LL~!Y-~N~ I~LATI~ ~I~fl~S~ C~ PRI~ TO T~ ISSUA~E <br /> _._~_~z~?:__~)_ I~ IHE RE~I~ILITY OF T~ AP~I~NT ~ ~URE THAT A~ <br /> mt~H~ Z~ TI~ IS P~i~D AS ~N AS ~ REGU~NTS ~ THE REVIEW <br /> <br /> SZGNATUEE OF APPLICANT: <br /> <br /> ~ONAL~ E. WOODLEY, HARION COUNTY EUIL~INO OFFICIAL / ~Y PHUNRO <br /> <br />.............. F~ ~FICE USE O~Y. THIS IS ~T A P~IT~ ........... <br /> HAP: ~ Z~; EFU P~RTY LOCATe. B~I~ ~I~B <br /> ~PTIC REVIEW: DATE: ZONING REVXEW; ~TE: <br /> <br /> <br />