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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) 373-4427 <br /> <br />ON-SITE APPLICATION <br /> <br />DATE/TIHE <br />TYPE <br />OCCUPANCY <br />PAGE <br /> <br />07/16/96 15:31 ACTIVITY NO <br />SP STATUS <br />R.3 SE APPLIED <br />I SP APPLIED <br /> TO EXPIRE <br /> <br />~11997 <br /> <br />WORK ])ESI: : AUTH/FLD S TO 4 BEDRMS <br /> <br />EXIST BEDEOOHS: <br />EXIST EMPLOYEE: <br /> <br />PROPOSED BEDRODHS : 4 <br />PROPOSED EMPLOYEES: <br /> <br />SITE ADDRESS : <br /> <br />CITY COUNTY <br /> <br />10714 SILVER FALLS HY SE AM <br /> <br />SUBDIVISION : <br /> <br />BLOCK: <br /> <br />CROSS STREET : WALDO HILt. DR SE <br /> <br />PARCEL NUHBER : 56835-000 <br /> PARCEL SIZE : 2,5AC <br /> <br />OWNER : WAIT~ED A & DONNA L ASHTON <br />AT)DRESF; : 10714 SIL.¥ER FALLS HWY SE <br /> AUMS~ILLE~ OR <br /> 97SB6 <br />PHONE : <br /> <br />A!!TH AGENT <br />ADDRESS <br /> <br />DALES REMODELING INC <br />55~4 COMHERCIAL ST SE <br /> <br /> SA[.EH~ OR 9: <br />PHONE : ,~70-7&09 <br /> <br />DEQ INSTALLER <br /> <br />DEQ LICENSE: <br /> <br />F'HONE : <br /> <br />Units D~,,/.i: r :i. ~tion Fee <br /> T <br /> DEQ Surcharg~ 30.00 <br /> <br /> Assessed fees : 247.00 <br /> AdjustMents : <br /> Total ~ 247,00 <br /> PAYF:E: DALES REflOD~ INC ' ' ..~ .0~ <br /> ~.? ..... !..,~....~. 247.00 <br /> <br /> THIS I~ NOT A THIS APPLICATION HIJST GO THROUGH <br /> SOIL, FEASABIL AND INSTALLATION REQUIRENENTS ARE CHECKED PRIOR TO THE ISSUANCE <br /> OF A PERNIT. IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL <br /> NECESSARY IS PROVIDED. AS SOON AS ALL REOU1RENENTS OF THE REVIEW <br /> HAVE BEEN , YOU WILL BE NOTIFIEB. <br /> <br /> SIGNATURE OF APPLICANT: <br /> <br /> DONALD E. WO!i)DIEY~ MARION COUNTY BUILD!:Nf~ OFFICIAL / BY CLYNCH <br /> <br />................ FOR OFFICE USE ONLY. THIS IS NOT A PERHIT .................. <br /> HAP: 46R ZONE: EFU PROPERTY LOCATOR: 081W17C 01088 <br /> <br /> SEPTIC REVIEW: DATE: ZONING REVIEW: DATE: <br /> <br /> <br />