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MARION COUNTY BUILDING INSPECTION <br /> COMMUNI'FY 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) 588-7904 <br /> <br /> ON-SITE APP[.ICATION <br />I)ATE/T)ME : li)2/16/96 15:19 ACTIVITY NO : ?6-81006 <br />TYPE : SP STATUS : APPLIED <br />OCCUPANIiY : R-3 APPLIEl) : 02/16/1996 <br /> TO EXPIRE : 08/14/1996 <br /> PAGE 1 <br /> <br />W('d:;,'l( ~F%(: : SP:NFW TNSTAI. [. FOR NFW RES <br /> <br />!-. X)~l FHF"I OYFE: F'ROF'['ISIF')') I:..-I'il.--'l. flYFFS~ <br /> <br />S'I;I'E Ai)'I)RI:-JSS ;: I;ZI;'I'Y: A!IR)RA :1465.4 t'(~S!i:l. C.T lql:: fir <br /> <br />~-;I!!'.(OTV/iS);OI,I : KASt-(I. COIIRT F:'H 2 <br /> <br />!.. 0 T ~: 1. ',.')B L 0 C K ~: <br /> <br />(']'<O,C;S S'I I:;~Fll!:"l[' : A) Fi:F'[IRT Fi'l) <br /> <br />I')WtiER <br /> NAHF' <br /> A!)i)RFS.S <br /> <br />F:'HI'dqF' <br /> <br />At::'F'I. !i CANT <br /> NAHIF' <br /> <br />PHI'ii,IF' <br /> <br />: CRFfii;FR,DAV.T)) & YA[ <br /> PO 8rlx <br /> AttRORA <br /> <br />: 678-.1577 <br /> <br />'OFJ; r:~)NTRACi'OR: HOI ALIA EXCAVAlmi:Nf;. <br /> / Ai';I:!,!'f' : f..-:RI:fi(:.FF:.',~.f':,AVTI:, & VAI. E:R]K <br /> !:'I.-! )FIE: : (.5~:~) l:1.79-9t:'~:1. <br /> <br />DEC) LI:CEI,tSE: ,:~7'1.2:1. <br /> OC(.';B: <br /> <br />I T)~.Q St! r,.': h a r fi~-:'. 3G,, <br /> <br /> Assess,':,.d 'fees:.. : S82. <br /> Ad justm~:,nt's : . <br /> 'l'ot',~l fees : S82,, <br /> <br />F'AYI:;I:(~ i;RF-.I'iI';F:R1 'OA¥ I; i) & VAI F;R I;E 8a 'J. af'~c~.) i:tue : ;:.q!) ~.~ ,, <br /> <br />THIS IS NOT A PER~[T. THIS APPLICATION ~UST 60 THEOUCH A EEVIE~ PROCESS WHERE <br />S~IL~ FEASA~ILITY AMP INSTALLATION REBUIRE~ENTS ~E CHE6KE~ P~[OE TO THE ISSUANCE <br />OF A PER~IT. IT IS THE ~ESPONSIB[LITY QF THE APPLICANT TO ASSURE THAT ALL <br />NECESSARY INFOR~AT)O~ IS PROVI~E~. AS SOON AS ALL EEgUIRE~ENTS OF THE <br />HAVE BEEN ~ET~ Y)lll ~[LL BE <br /> <br />q ]'(';I,.IA'i'IIRF OF: AF'Pt ] CAN'I': <br /> <br />Ii(H,fAf )) I:,. W(iO)~! FYi. HAtTiON COIIt,FIY l.:d l ]' l. . fi :i lq (, (')F'F)CIAI.. / BY <br /> <br /> FOE OFF[CE USE ONLY. TH~S IS ~OT ~ PER, IT .................. <br />MAP: S ZONE: RS PROPERTY LOCATOR: B41WI2CBO258e <br /> <br />~EPTIC REVIEW: ~ATE: ZONlW~ ~EVIEW: DATE: <br /> <br /> <br />