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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY 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 APPLICATION <br />DATE/TIME : e4/17/96 09:21 ACTIVITY NO : 96-B2472 <br />TYPE .- SP STATUS -' APPLIED <br />OCCUPANCY : R-3 APPLIED : <br /> TO EXPIRE : 10/~?/1996 <br /> - . PAGE <br /> <br />WORK DFSC : RFPI ACF 24X4R ~--~DRM MD W/27X48 S-~DRM MD <br /> <br />EXIST BEDROOMS: S PROPOSED BEDROOMS : 3 <br />E'~'IST FMF'LOYEE: PROF'OSED EMPLOYEES: <br /> <br />SITE Al)DRESS : CITY: MARION COUNTY <br /> 13620 WISTERIA DR NE AR <br /> <br />SiJBDIV'[SION : DEER CK EST .f2 <br />CROSS STREET : BOONS FERRY RD <br /> <br />PARCEl. I,IIJMBFR : 7:1. g11~-8S0 <br /> PARCEL SITE : 10000.0SF <br /> <br />ONNER <br />NAME : SPRINGFR~ ,IOHI,I <br />Al)DRESS : N/A <br /> <br /> PHONE : N/A <br /> <br />APF'LICANT <br />NAME : ROEHM .JOHN A <br />ADPRESS : 17277 S FERNWOOD <br /> <br /> MOl.Al.LA, OR <br /> PHONE : R29-487.1 <br /> <br />DEQ C~)NTRACTOR: ROEHM .H']HN A <br /> / A(iFNT : ROFIqM ,J[HN A <br /> F'HONE : 8,~.9-4871 <br /> <br />LOT: '2 BLOCK: 1'2 <br /> <br />970:~8 <br /> <br />97038 <br /> <br />DEQ L. ICENSE: <br /> OCCB: 009633~ <br /> <br />[In:i t's Description ~ Fee <br />--T-. ............ 7~iTi ~-F~T~-'[q~-~'~'" ~ ...................................................... <br /> ~ DFQ Surcharge S0.00 <br /> <br /> Assessed fees : 247.00 <br /> Adjustments : .00 <br /> t'nta 1 f~:es : 247. <br />PAYEE: ROEHM JOHN A Total payments: 247. <br /> Balance due : <br />*********************************************************************************************** <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 BEJ~I~. ~ ~ ~ <br />SI~NA'FURE OF AF'PLICAIqT~~~~ r~ ~ <br />DONALD El. WOOD. EY, MARION COUNTY R~JlL. DIN~ OFFICIAl.. / BY DSTOIqE ~/~' <br /> <br /> FOR OFFICE USE ONLY. THIS IS NOT A PERMIT <br />MAP: SR ZONE: AR PROPERTY LOCATOR: 041WllBC00200 <br /> <br />SEPTIC REVIEW: DATE: ZONINC REVIEW: DATE: <br /> <br /> <br />