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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 /> <br />DATE/TTNE = Bt/23/97 <br />TYPE -' SP <br />OCCUPANCY : R-3 <br />PA~E : <br /> <br />15=29 <br /> <br />ACTIVITY I~ = 9&-88241 <br />STATUS : APPLIED <br />SE APPLIED = 18/1~ <br />SP APPLIED ~ 1~/1&/1996 <br />TO EXPIRE <br /> <br />WORK DESC : SP:INSTALL FOR FURTURE MANFG-3-BDRfl HOME <br /> <br />EXIST BEDROOMS: PROPOSED BEDROOMS : 3 <br />EXIST EMPLOYEE: PROPOSED EMPLOYEES: <br /> <br />SITE ADDRESS : <br /> 10647 [EYERMAN RD SE AM <br /> <br />CITY: MARION COUNTY <br /> <br />SUBDIVISION : <br /> <br />CROSS STREET : MILl. CREEK RD SE <br /> <br />PARCEL NUMBER : 56466-250 <br /> PARCEL SIZE : 2.5AC <br /> <br />LOT: BLOCK: <br /> <br />OWNER : CONKLIN, RALPH & PATRICIA <br /> ADDRESS : 1951LABONA DR <br /> E~JGENE, OREGON <br /> <br />PHONE : 541-688-6144 <br /> <br />AUTH AGENT : <br /> ADDRESS : <br /> <br />PHONE : <br /> <br />DEQ INSTALLER : <br /> <br />PHONE <br /> <br />Units Description Fee <br /> ~ 'Construction Permit <br /> DFQ Surcharge <br /> <br />LICENSE.' <br /> <br /> Assessed fees : 382.00 <br /> AdjustMents : .00 <br /> Total fees : 382.88 <br />PAYEE: Total payments: 382.80 <br /> Balance due : <br /> <br /> THIS IS NOT A PERNIT. THZS APPLICATION NUST GO THROUGH A REVIEW PROCESS #HERE <br /> SOIL, FEASIBILITY AND INSTALLATION REQUIREHENTS ~RE CHECKED PRIOR TO THE ISSUAI~J~E <br /> OF A PERMIT. IT TS THE RESPONSIBILITY OF THE /~=t=LICANT TO ASSURE THAT ALL <br /> RECESS~RY IMFORI~TION IS PROVIDED. AS SOON AS ALL REGUIREHENTS OF THE REVIE# <br /> HAVE BEEN MET~, YOU WILL..Br~NOTIFIE]). j // . <br />SIG.ATL,RE 0r APPLICANT,L"/ /Z, _ n <br />*************************--**--*********************************** <br />................ FOR OFFICE USE ONLY. TNIS IS NOT A PERMIT ...... -~-~--~--~--~ ...... <br /> I~P: 48 ZONE= AR PROPERTY LOCATOR: 881N29c/e26ee <br /> <br /> SEPTIC REVZE~= DATE= ZONING REVIEI~: DATE= <br /> <br /> <br />