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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) 373-4427 <br /> <br />OH-SITE APPLICATION <br /> <br />DATE/TIHE : 07/10/96 <br />TYPE : SP <br />OCCUPANCY : R-1 <br />PAGE : I <br /> <br />16:31 <br /> <br />ACTIVI <br /> <br />SE <br />SP <br /> <br />NO 96-0486~ <br /> APPLIED <br /> <br /> 12/21996 <br /> <br />WORK DEE;('; : SEPT}C PUMP FOR SS 95-17592 <br /> <br />EXIST B~DRO('.)NS:~ PROPOSED BEDROOMS : <br />EXIST EMPLOYEE;: PROPOSED EMPi OYEES: <br /> <br />SITE ADDRESS : <br /> 21356 HUBBARD CUTOSF NE AR <br /> <br />SUBDIVISION <br /> <br />CR(ISS STREET : <br /> <br />PARCEI NHMBER : 40~79-000 <br /> PARCEL SIZE : .OAC <br /> <br />OWNER <br />NAME : W~,~TERN WAGON, VILLAGE <br />ADDRESS <br /> <br />Pl~i]i'J,E : <br /> <br />A) ~ L.,CANT <br /> NAME <br /> A)~DEESS <br /> <br /> PHONE <br /> <br />!)E(~ CONTRACTOR: BEAR ELECTRIC <br /> / AGENT : BEAR EL.ECTR <br /> PHONE : 982-9507 <br /> <br /> U~li i~s Descri <br /> <br />97 <br /> <br />BEAR ELECTRIC INC <br />P(I BOX :(B9 <br />20985 BUTTEVIi. I,E NE <br />DONALD OR 97020 <br />982-9507 <br /> <br /> CITY: MARION COUNTY <br /> <br />LO'F: BLOCK: <br /> <br /> DEQ I..,~CEN~E.. <br /> OCuB. <br /> <br /> Assessed fees : 25.00 <br /> Ad just~e;T~s : .00 <br /> 'f~ta] fees : 25.88 <br />F'AYE'E: BEAI II,lC 'Fot~:~l p~y~)e~ts: 25, <br /> Balance due : .08 <br />~******~ *************************************************************************** <br /> <br />THIS IS NOT A PERMIT· THIS APPLICATION MUST ~0 THROUGH A REVIEW PROCESS WHERE <br />SOYL, FEASABI~ITY AN~ INSTALLATION REQUIREMENTS ~E C~CKED PRIOR TO THE ISSUANCE <br />~ A~PER~IT. IT IS THE RESPONSIBILITY OF THE APPklCANT TO ASSURE THAT <br /> CE,.SARY INFORMATION IS PROVI~E~. AS SOON AS AkE REQUIREMENTS OF THE REVIEW <br />HAVE BEEN MET, YOU WILL BE NOTIFIEB. <br />S!GNA]URE O; APP(ICAN'F: <br /> <br />DONA~ D E~ WOODLEY~ NAR!ON COUNTY BUt~)IN~ OFFICIAL / BY CLYNCH <br /> <br />................HAP~ FO~O~I~uUSE ONLY. THISpRoPE~TyES NOTLo[~ToR:A PERMITo41WI4B .................. <br /> <br />SEPTIC REVIEW. DATE: ZONING REVIEW: DATE: <br /> <br /> <br />