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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 /> OH-SITE APPLICATION <br />D~TE/TIHE : ~4/03/97 10=I~ ACTIVZTY NO : 97--82235 <br />TYPE = SP STATUS = APPLIED <br />OCCUPAHCY : R-3 ~APPI. IED : ~4/~3/1~7 <br />PAGE = 1 SP ~XED = e4/B3/1997 <br /> TD E~[RE = ~9/3~/[9~7 <br /> <br />WORK DESC : ESE PARTITION PARCEL I OF 2 <br /> <br />EXIST BE~ROOMS: 4 PROPOSED BEDROOMS ~ <br />EX~ST EMPL. OYEE= PROPOSE~ EMPLOYEES= <br /> <br />SITE ADDRESS : CITY~ MARION COUNTY <br /> 7877 ~AR~ARA LN SE AM <br /> <br />SUBDIVISION : <br /> <br />CROSS STREET : VICKI LN <br /> <br />PARCEL NUMBER : 74118-870 <br /> PARCEL SIZE : 2.88 AC <br /> <br />LOT: BLOCK: <br /> <br />OWNER NELSDN.C IAN & KATHLEEN ~ <br /> ADDRESS ~ P 0 DO× 336 <br /> STAYTON, OR <br /> 97383 <br /> PHONE : 583-769-1214 <br /> <br />AUTH AGENT <br /> ADDRESS <br /> <br /> PHONE : <br />DEQ INS'I'AU. ER : <br /> <br /> PHONE : <br /> <br />NELSON.C IAN & KATHLEEN <br />P 0 BOX 336 <br />STAYTON~ OR <br /> 97383 <br />583-767-12~4 <br /> <br />SANI-TECH <br /> <br />(58~) 364-7478 <br /> <br />Units <br /> <br />OEO LICENSE: 35767 <br /> <br /> Fee <br /> <br /> Description <br />1 Existing System Evaluation 217.88 <br />I DEO Surcharge 38.88 <br /> <br />............... FOR OFFICE; USE ONLY. <br /> ~: 4SR ZONEr AR <br /> <br />SEPTIC REVIE#: <br /> <br /> Assessed fees : 247.88 <br /> Adjustments : <br /> Total fees : 247.80 <br />PAYEE: NELSOH,C IAfl & KATHLEEN Total pa~nents: 247.08 <br /> Balance due : <br /> <br />THIS IS HOT A PERItlT. THIS APPLICATION HUST gO THROUGH A REVIE# PROCESS WHERE <br />80IL, FEASABILITY AND INSTALLATION RE(IUIREHENTS NtE CHECKED PRIOR TO THE ISSUANCE <br />OF A PER#IT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL <br />NECESSARY INFORNATION IS PROVIDED. AS SOON AS ALL REGUIRENENTS OF THE REVIE# <br /> <br />SIGNATURE OF APPLICANT. ~,---- ~ <br /> <br />DONALD E. WOODLEY, NARION COUNTY BUILDING OFFICIAL / DY CLYNCN <br /> <br /> THIS IS HOT A PERHIT <br /> PROPERTY LOCATOR: ~6~#28C <br /> <br /> BATE: ZONING REVIEW: UATE~ <br /> <br /> <br />