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DATE/TIME <br />TVPE <br /> <br />04/24/98 12:33 <br />SE <br /> <br />ON-SITE APPLICATION <br /> <br />WORK DESC <br /> <br />EXIST BEDROOMS: <br />EXIST EMPLOYEE: <br /> <br />SITE ADDRESS <br /> <br />SUBDIVISION <br />TAX ACCOUNT <br /> <br />APPLICAICT <br />ADDRESS <br /> <br /> PHONE <br /> <br />OWNER <br /> ABDRESS <br /> <br />SE: LOT~OF 3 ESE:98-03186 <br /> ~FROPOSED BEDROOMS : <br /> PROPOSED EMPLOYEES: <br /> <br /> 8731 HOLMQUIST RD SE AM <br /> <br /> LOT: <br />~-~"l PARCEL: <br />CLARAMBEAU,CRAIG <br /> PO BOX 11 <br />STAYTON <br />OR 97383 <br />502-932-2270 <br /> <br />1.50 AC <br /> <br />PHONE <br /> <br />97383 <br /> <br />ACTIVITY NO <br />STATUS <br />SE APPLIED <br />SP APPLIED <br />TO EXPIRE <br /> <br />LOCAIUR: <br /> CITY: <br /> <br />98-03188 <br />APPLIED <br />04/24/1998 <br />00/00/0000 <br />10/21/1998 <br /> <br /> ZONE: AR <br />MAP: 48R <br />LAND USE: P98-009 <br /> <br />BL: <br /> <br />DEQ LICENSE: 37698 <br /> <br />DEQ INSTALLER SEP-TECH EXCAVATION <br /> PHONE 503-364-0332 <br /> Units Description Fee <br /> 1 S~te evaluation 247.50 <br /> 1 DEQ Surcharge 30.00 <br /> <br /> Assessed fees : 277,50 <br /> Adjustments : .00 <br /> Total fees : 277.50 <br /> PAYEE: CLARAMBEAU,CRAIG Total payments: 277.50 <br /> 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 OP THE APPLICANT TO ASSU~E THAT ALL <br /> NECESSARY INFORMATION IS PROVIDED. AS SOON AS ALL REQUIREMENTS O~ THE REVIEW <br /> HAVE BEEN MET, YOU WILL BE/~,TIFIED. ,~ /I <br /> SIGNATURE OF APPLICANT: ~-/-~ ~ ~ <br /> <br /> Marion County Building Inspection <br /> 3150 Lancaster Dr. N.E., Suite C Salem, Oregon 97305-1398 <br />Office Hours: B:00.4:30 Phone: (SD3)58B-5147 24-hr Inapection Line: (503)373-4427 <br /> <br /> <br />