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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C · Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br /> OH-SITE APPLICATION <br />DATF/TINF = 95/9?/97 ]A=19 ACTIVITY NO = 97-93185 <br />TYPE = ~P STATUS = APPLIED <br />O~t~N~CY = R-3 SE APPLIED : 95/92/1997 <br />PAgE = ! SP APPLIED ; 95/92/1997 <br /> TO EXPIRE = 18/27/1797 <br /> <br />WORK DF~C : <br /> <br />EXIST BEDROOMS: 2 PROPOSED BEDROOMS : 2 <br />FXIST FNPIOYEE: PROPOSED EMPIOYFF~: <br /> <br />SITE ADDRESS : CITY: MARION COUNTY <br /> 2~82] ~ODNFS FERRY RD NF AR <br /> <br />SIJBDIVlSION : LOT: BLOCK: <br />CRO,~ STRFFT : EH[ Eft RD <br /> <br /> PARCEl 817F : ].~8 AC <br /> <br />OWNER : HAAK~ STEPHEN <br /> ADDRESS : FERRY RD NF <br /> 21871BOONE~ <br /> AURORA OR <br /> 9780? <br /> PNONE : 678-~31 <br /> <br />AU]H AGFNT <br /> ADDRESS <br /> <br /> PHONE <br /> <br />OEO INSTALLER <br /> <br /> PHONE <br /> <br /> 1 <br /> <br /> HAAK~ STBPHEN <br /> 21821BOONES FERRY RD NE <br /> AURORA OR <br /> 97882 <br /> <br /> DEQ LICENSE: <br /> <br /> O~cri~t'[on Fee 217.00 <br /> DEQ Surcharge 30.00 <br /> <br /> Ad~ustMeDts <br /> <br /> Balance ~ue : <br /> <br /> THIS IS NOT A PFRNIT. THIS APPLICATION HUST GO THROUGH A REVIEW PROCESS WHERE <br /> ~ii~IL~ FEASASILITY AND THSTALLATIQN ~QUIREHEHTS ~E ~CKE~ ~IOR TO THE ISSUANCE <br /> A PE~IT. IT IS THE RE~IBILITY OF T~ A~IC~T TO ASS~E T~T ALL <br /> ~9~RY t~OR~TtOH IS PROVIDED~ ~S SO~ AS ALL REGUIREHEHTS OF THE REVIE~ <br /> <br /> SI&NATuRE 0F APPLICANT=~~ <br /> <br /> DOHAI.D E. WOODI.EY, M~RION COUNTY ~UILDING OFFICIAL / BY PMUNRO <br /> <br />................ F~ OFFICE U~ ~LY. PRDE~TY I,~T~. I~I~llC~i~5~ THIS IS NOT A PER?T ................. <br /> H~: ~ Z~E: ~ <br /> <br />SEPTIC REVIEW: <br /> <br /> <br />