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DATE/TIME <br />TYPE <br /> <br />04114/98 14:10 <br />SP <br /> <br />ON-SITE APPLICATION <br /> <br />ACTIVITY NO <br />STATUS <br />SE APPLIED <br />SP APPLIED <br />TO EXPIRE <br /> <br />b,~RK DESC ESER:LOT LINE ADJ <br /> <br />EXIST BEDROOMS: 3 <br />EXIST EMPLOYEE: <br /> <br />PROPOSED BEDROOMS : <br />PROPOSED EMPLOYEES: <br /> <br />SITE ADDRESS <br /> <br />11814 EHLEN RD NE AR <br /> <br />SUBDIVISION <br />TAX ACCOUNT <br /> <br /> LOT: BL: <br />40739-000 PARCEL: 66.12 AC <br /> <br />APPLICANT <br />ADDRESS <br /> <br />PHONE <br /> <br />PAVLICEK VINCE AGENT <br />2225 MADRONA LN <br />CANBY <br />OR <br />503-266-25~6 <br /> <br />97012 <br /> <br />OWNER <br /> ADDRESS <br /> <br />PHONE <br /> <br />MARTILLA,WILSZE E & KATHERINE <br />11814 EHLEN RD NE <br />AURORA. OR <br /> 97012 <br />502-678-5357 <br /> <br />98-02122 <br />CANCEL <br />02/20/1998 <br />02/20/1998 <br />04/14/1998 <br /> <br />LOCAIOR: U41W16 UU600 <br /> CITY: MARION COUNTY <br /> <br /> ZONE~ EFU <br /> MAP: 4R <br />LAND USE: LLA 98-3 <br /> <br />DEQ INSTALLER DEQ LICENSE: <br /> PHONE <br /> Units Description Fee <br /> 1 Existing System Evaluation 217.00 <br /> 1 DEQ Surcharge 30,00 <br /> I Refund -247,00 <br /> <br /> Assessed fees : .00 <br /> Adjustments : .00 <br /> Total fees : .00 <br />PAYEE: PAVLICEK VINCE AGENT Total payments: .00 <br /> WILSIE MARTILLA & KATHERINE Balance due : .00 <br />*********--***********--*****--*********************--************** <br />THIS IS NOT A PERMIT, THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE <br />SOIL, FEASABILITY AND INSTALLATION REQUIREMENTS ARE CHECKED PRIOR TO THE ISSUANCE <br />OF A PERMIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL <br />NECESSARY INFORMATION IS PROVIDED, AS SOON AS ALL REQUIREMENTS OF THE REVIEW <br />HAVE BEEN MET. YOU WILL BE NOTIFIED. <br /> <br />SIGNATURE OF APPLICANT~ <br /> <br />DONALD E, W~]ODLEY, MARION COUNTY BUILDING OFFICIAL / BY KD~HL <br /> <br /> Marion County Building Inspection <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)373-4~27 <br /> <br /> <br />