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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 /> (IS-SITE APPLIC&TION <br />DflTE/TI~E = ~4/B3/97 1&.'~1 ~CTIVITY NO g 97-gPP3& <br />TYPE '- SE STATUS : APPLXE~ <br />OCCUP~CY : R-3 SE APPLIED : ~4/~3/1997 <br />PA~E ~ I SP APPLXE~ -' &4/~3/1997 <br /> TS EXPIRE : S9/3~/1997 <br /> <br />WORK DESC : SE: PARTITION PARCEL 2 OF 2 <br /> <br />EXIST BEDROOMS: PROPOSED BEDROOMS : 4 <br />EXIST EMPLOYEE: PROPOSED EMPLOYEES: <br /> <br />SITE AOOEESS : CITY: MARION COUNTY <br /> 7867 BARBARA LN SE AM <br /> <br />(:ROSS STREET : VICKI LN <br /> <br />PARCEL NUMBER : 7411~-870 <br /> PARCEL SIZE : 1.50 AC <br /> <br />LOT: BLOCK: <br /> <br />OWNER <br /> ADDRESS : <br /> <br /> PHONE : <br /> <br />AUTH AGENT <br />ADDRESS <br /> <br /> NELSOfl, C IAN & KATHLEEN <br /> P 0 BOX 336 <br /> STAYTON, OR <br /> 97383 <br /> 5~3-769-12t4 <br /> <br /> NELSON,C IAN & KATHLEEN <br /> P 0 BOX 336 <br /> STAYTON, OR <br /> PHONE : 503-767-1214 97383 ~_ <br />DEOPHONEINSTAI. LEE :: SANI-TECH(503) 364-7470 ~/~ DEQ LICENSE: 35767 <br /> Units Description Fee <br /> 1 Site evaluation <br /> 27B.00 <br /> I DEQ Surcharge 30.00 <br /> <br /> Assessed fees : 320.00 <br /> Adjustments : <br /> Total fees : 320.00 <br />PAYEE: NELSON, C IAN & KATHLEEN Total paxments: <br /> Balance due : .00 <br /> <br />THIS IS HOT A PERHIT. THIS APPLICATION HUST gO THROUGH A REVIEU PROCESS UHERE <br />~It, FgA~SICITY mD I~T~LATION ~I~£.TS ~ ~E~£~ P~IOR TO THE ~S~ANC£ <br /> PERHIT. IT IS THE RESPOI~ISILITY OF THE ~PPLIC~ TO ASSURE THAT ALL <br />NECESSARY INFORH~TION IS PROVI~E~. AS ~OON A~3 ~ REQUIRE#ENTS OF THE REVIE# <br />14~flE ~EEH I~, YOU UIL~ BE~T~FIB.~ <br />SI NATUEE OF APPLICA.T. , <br /> <br />DONALD E. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY CLYHCN <br /> <br /> · FOR OFFICE USE OI~Y. THIS IS HOT A PERHIT ............... <br />MAP: 48R ZOHE: AR PROPERTY LOC~TON: 881U28C <br />SEPTIC REVIEW: DATE: ZO#IH(; REVIEW: ~TE: <br /> <br /> <br />