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MARION COUNTY BUILDING INS PECTION <br />COMMUNrTY DEVELOPMENT CENTER <br /> <br /> ~M Ohuroh 8tract NE · Room 182 · 8mlem, Ormoon 97801-~T0 <br />OCfloe Houm: 8:00-~:~0 · Phone: (508) ~88-~147 · ~4-HR InepeMIon Line: (~08) <br /> <br />ON-SITE APPLICATIOH <br /> <br />DATE/TIHE ~ 84/24/96 14:18 ACTIVITY NO ~ 96-82887 <br />TYPE : SP STATUS : APPLIED <br />OCCUPANCY' : R-3 APPLIED : <br /> TO EXPIRE : 18/21/1996 <br /> PAGE I <br /> <br />WORK DESC : ALT;ABOND OLD INSTALL NEW-NOT FAILING <br /> <br />EXIST BEDROOMS: <br />EXIST EMPLOYEE: <br /> <br />PROPOSED BEDROOMS : <br />PROPOSED EMPLOYEES: <br /> <br />SITE ADDRESS : <br /> <br />8975 SHAW SQUARE SE AM <br /> <br />CITY: MARION COUNTY <br /> <br />SUBDIVISION. : LOT: BLOCK: <br /> <br />CROSS STREET : SILVER FALLS HY <br /> <br />PARCEL. NUMBER : 75300-361 <br /> PARCEL SIZE : 1.4AC <br /> <br />OWNER <br />NAME. : AMSBERRY,¥ELON~ B <br />ADDRESS : 8973 SHAW SQUARE RD SE <br /> AUMSVILLE, OR <br /> <br />PHONE : <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br />: CA CONSTRUCTION <br />: 518 VALLEYWOOD DR SE <br /> SALEM,OR <br /> <br />PHONE : S63--1711 <br /> <br />DEQ CONTRACTOR: CA CONSTRUCTION <br /> / AGENT : CA CONSTRUCTION <br /> PHONE : S6S--1711 <br /> <br />97S86 <br /> <br />97S86 <br /> <br />DEQ LICENSE: <br /> OCCB: 8898940 <br /> <br />U~*~its Desc.~':. ~ p.4~.i_ on ~ee <br />T; Alteration <br />1 DEQ Surcharge ~0.00 <br /> <br /> Assessed fees : ~78.88 <br /> AdjustMents : .80 <br /> Total fees : ~78.08 <br />PAYEE: CA CONSTRUCTION Total paxMents: ~78.88 <br /> Balance ~ue : .88 <br />********************************************************************************** <br /> <br />THIS IS NOT A PERHIT. THIS APPLICATION HUST GO THROUGH A REVIEW PROCESS WHERE <br />SOIL, FEASABILITY AND INSTALLATIOH REQUIREHEHTS ARE CHECKED PRIOR TO THE ISSUANCE <br />OF A PERHIT. IT IS THE RESPOHSIBILITY OF THE APPLICAHT TO ASSURE THAT ALL <br />NECESSARY INFORHATION IS PROVIDED. AS SOOH AS ALL REOUIREHEHTS OF THE REVIEW <br />HAVE BEEN .HET, YOU WILL BE~. . <br /> <br />MAP: 51 ZONE: AR PROPERTY LOCATOR: 882W13C 85481 <br /> <br />SEPTIC REVIEW: DATE: ZONING REVIEW: DATE: <br /> <br /> <br />