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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Churclt Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone; (503) 568-5147 * 24-HR InspeCtion Line: (503) 373-4427 <br /> <br /> 0N-~ITEAPPLI~ATZON <br />DATE/TIME : ~3/14/77 lB:B6 N~TIVITY NO : 97-~17~1 <br />TYPE : SP STATUS : ~LI~ <br />OCCUP~Y : R-3 ~ ~IED : ~3114/1~ <br />PAGE : I ~ ~LIED : ~3/14/1997 <br /> TO ~PI~ : B9/1~/1~97 <br /> <br />WORK DESC : SEPTIC AUTH/HtSTORY <br /> <br />EXIST BEDROOMS: 2 PROPOSED BEDROOMS : <br />EX~ST EMPLOYEE: PROPOSED EHPLOYEES: <br /> <br />S~TE Al)DRESS : CITY: ~ETROIT <br /> 148 LAKE ST BT <br /> <br />SUBDIVISION : <br /> <br />CROSS STREET :HILL ST <br />F'ARCEL NUMB~ ~ 66936-808 <br /> PARCEL SIZE ~ 9388.88 SF <br /> <br />LOT: BLOCK: <br /> <br />OWNER : RICH RODGERS <br />ADDRESS : 18880 BOYNTON ST <br /> OREGON CITY, OR <br />PHONE : 58~-655-6224 <br /> <br />97845-3917 <br /> <br />A(ITH AGENT : RICH RODGERS <br />ADDR .SS : 18888 BOYNTON ST <br /> OREGON CITY, OR <br />PHONE : 583-655-6224 <br /> <br />OEO TNS'FAL. LER : <br /> PH(INE : <br /> <br /> U__nits <br /> ! <br /> 1 <br /> <br />97845-3917 <br /> <br />Description <br /> Authorization w/Field Visit <br /> DEQ Surcharge <br /> <br />DEQ LICENSE: <br /> <br />FeE <br /> 217.~0 <br /> 38.88 <br /> <br /> Assessed fees : 247.88 <br /> AdjustMents : <br /> Total fees : 247.08 <br /> PAYEE: RICH RODGERS Total paxMents: 247.88 <br /> Balance Uue · .88 <br /> <br /> PROCESS <br /> ~HERE <br /> OF A PERMIT ~ .............. _~_. _~._~UIREMENTS ~RE CHECKED PRIOR TO THE ~SSUAHCE <br /> ........... ~__!!.i~_~.n~ ~m"u~"~l~lLIlY OF THE A~LIC~HT TO A~RE T~T <br /> ~ iNPUK~II~ IS PROVI~V~ AS SOOH ,AS ALL REQUiREMEHT~O~ <br /> H~v~ B~N ~T, YOU ~ILL BE ~TIFIED. <br /> <br /> S~GNATURE OF APPLICANT: <br /> <br /> DONALD E, WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY ~YON ~-~ <br />................ FOR OFFI~ g~ ~LY. THIS I~ ~OT A,P~RMIT <br /> MAP: 185 ZONE: RS PROPERTY L~TOR: <br /> SEPTIC R~IEW~ D~TE~ ZOHIHG R~IEW~ DATE~ <br /> <br /> <br />