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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 APPLICATION <br />DATE/TINE : S3/18/77 15:47 ~CTIVITY NO : 77-81572 <br />TYPE : SP STATUS : APPLIED <br />OCCUP~HCY = R-3 SE ~PPLIED = 83/18/1797 <br />PAGE : I SP APPLIED = 83/18/1977 <br /> TO EXPIRE = 89/86/1777 <br /> <br />WORK DESC : AIITH-FIEL. D VISIT/REPLACE 2 BEDROOM W/3 <br /> <br />EXIST BEDROOMS: 2 PROPOSED BEDROOMS : 3 <br />EXIST EMPLOYEE: PROPOSED EMPLOYEES: <br /> <br />SITE ADDRESS : MARION COUNTY <br /> 12364 WEST STAYTON RD SE AM <br /> <br />SURD[VISION <br /> <br />CROSS STREET : STAYTON RD <br /> <br />PARCEL NUMBER : 75718-120 <br /> PARCEt. SITE. : .78 AC <br /> <br />BLOCK: <br /> <br />OWNER : THOMPSON.CURTIS D & MONA JO <br />ADDRESS : 12~64 W STAYTON ROAD <br /> AIJHSVILI.E~ OR <br /> 97385 <br />PHONE : 769-7853 <br /> <br />AHTH AGENT <br />ADDRESS <br /> <br />THOMPSON~ CURTIS & MONA <br />12364 W. STAYTON RD <br />SIAYTON OR <br /> <br /> PHONE : 76?-7853 <br /> <br />OEQ (NSI'ALLER : <br /> <br /> PHONE : <br /> Units Desc:r:i. ~tion <br /> 1 DEQ Surr:harg~ <br /> <br />gED LICENSE: <br /> <br />Fee <br /> <br /> 30.80 <br /> <br /> Assessed fees : 247.08 <br /> AdjustMents : .00 <br /> Total fees : 247.88 <br /> PAYEE: THOMPSON & MONA l'otal paxMents: 247.08 <br /> Balance ~ue : .0~ <br /> <br /> THIS IS NOT THIS APPLICATION HUST GO THROUGH A REVIEW PROCESS WHERE <br /> SOIL~ FEASADILITY AND INSTALLATION REOUIREHENTS ~RE CHECKED PRIOR TO THE ISSUANCE <br /> OF A PERHIT. IT IS THE RESPOHSISILITY OF THE APPLICANT TO ASSURE THAT ALL <br /> HECESSARY INFORNATION IS PROVIDED. AS SOON AS Nl REGUIREHEHTS OF THE REVIEW <br /> I~VE SEEN HET~ YOU WILL SE NOTIFIED. k A ~ <br /> <br /> ******************************************************************************* <br /> DONAU) E. WOODLEY, MARION COUNTY BUll_DING OFFICIAL / BY PMUN~ <br />................ F~ OFFICE USE ONLY. THIS IS NOT A PERNIT--/ ..... ~t~ ....... <br /> HAP: 68 ZONE: EFU PROPERTY LOCATOR= 871W18C 88188 <br /> <br /> SEPTIC REVIE#: DATE: ZONING REVIEW: DATE: <br /> <br /> <br />