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DATE/TIME <br />TYPE <br /> <br />: 05/25/99 10:11 <br />: SP <br /> <br />UGB: SITE: <br /> <br />ON-SITE APPLICATION <br /> ACTIVITY NO <br /> STATUS <br /> SE/SP APPLIED <br /> ISSUED <br /> TO EXPIRE <br /> <br />99-03989 <br />APRLIED <br />05/25/1999 <br />00/00/0000 <br />11/21/1999 <br /> <br />WORK DESC <br /> <br />EXIST BEDROOMS: <br />EXIST EMPLOYEE: <br /> <br />: AUTH/FLD FOR NEW 3/BED DWELL <br /> <br /> 2 PROPOSED BEDROOMS : <br /> PROPOSED EMPLOYEES: <br /> <br />SITE ADDRESS : <br /> <br />SUBDIVISION <br />TAX ACCOUNT <br /> <br />APPLICANT <br />ADDRESS <br /> <br /> PHONE <br /> <br />OWNER <br /> ADDRESS <br /> <br /> 10514 LEVERMAN RD SE AM <br /> <br /> LOT: <br />56456-000 PARCEL: <br /> <br />REUTOV NESTOR <br />12385 PORTLAND RD NE <br /> <br />GERVAIS, OR 97026-9999 <br />792-8684 <br /> <br />HOPKINS EDWARD J <br />10514 LEVERMAN RD SE <br />AUMSVI[[E OR 97325 <br /> 97026-9999 <br /> <br />LUCAIUR: UB1WSZ, A U120D <br /> CITY: MARION COUNI~{ <br /> <br /> ZONE: SA <br /> MAP: 48R <br />LAND USE: <br /> <br /> BL: <br />5.00 AC <br /> <br />DEQ INSTALLER: <br /> PHONE: <br /> <br />DEQ LICENSE: <br /> <br />PHONE 749-2021 <br /> <br /> Units Description Fee <br /> I Authorization w/Field Visit 250.00 <br /> I DEQ Surcharge 30.00 <br /> <br />Assessed fees : 280.00 <br /> <br /> Adjustments : .00 <br /> Total fees : 280.00 <br />PAYEE: REUTOV NESTOR Total payments: 280,00 <br /> Balance due : .00 <br /> <br />THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE <br />SOIL, FEASABILI~ 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 />SIGNATURE OFAPPLICANT: ~ ~,_-~, <br />DONALD E. WOODLEY, MARION COUN~ BUILDING OFFICIAL / BY MBULL <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)373-4427 <br /> <br /> <br />