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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 * Selem, Oregon 97301-3670 <br /> Office Hours: 8:00-4:30 · Phone: (503) 588-5147 * 24-HR inspection Line: (503) 3'/'3-4427 <br /> <br /> OH-SITE APPI ICATIOH <br />DATF/TIMF = 1g/2~/96 11.-J4 ACTIVITY NO : 96-08342 <br />TYPE : SP STATUS = APPLIED <br />ItCCtIPAHr, Y ; R-3 SE APPLIED : <br />PA~,E : ! SP APPLIED <br /> TO EXPIRE : 84/19/1997 <br /> <br />EXI~$T BE1)ROOH8:* ,3 PROPOSED BEI)RllOHS : <br />EX'fliT FHP[ [IYE[:: PROPJlSFD FMPI OYEES: <br /> <br />Hi~I'E A1)I)RESR ~ CITY: MARION COUNTY <br /> ~17~55 NFA~ ST SF AH <br /> <br />LOT: BLOCK: <br /> <br />OWNER <br /> <br />PHONE <br /> <br /> HrlI,I,'[N~SWORTH.AI,TA & ROBERT <br /> 4(84 RtlFNA V~STA RP H <br />JFFFFR80N <br />PR 97~57 <br />:~27-192] <br /> <br />AIITH AGFNT <br /> A~ORESS <br /> <br />HOllSN~$W(IRIH~A[I*A & RO~FRT <br />4684 BUENA VI9TA RD S <br />,IFFFFRRPN <br /> 97352 <br /> <br />4TAY1ON,~ MI. CTY & STI.VERI'ON SbTPT <br /> <br />I)EQ L. ILENSE. 34916 <br /> <br /> Fee <br /> <br />217.0f~ <br /> <br /> A~s~s~d fees : 247.00 <br /> Adjustmpnts : <br /> Total f~es : 24'7.88 <br />PAYFF: HOII~NGHWORIH~AITA & R('I~FRT Tota) payments: 247.00 <br /> Balance due <br /> <br />THI.~ I-~ HOT A PERMIT. TH'IS APPLICATIOI¢ HOST GO THROUGH A REVIE# PROCESS WHERE <br />.~(tTI. ~ FFA.q*~RILITY N, IB IH,~TI~ILAT*[OH RFQUIRFHENTS N~E CHECKED PRIOR TO THE ISSUANCE <br />OF A PERHTT. IT IS THE RE*~PONSIBILITY OF THE APPLICANT TO ASSURE TI'I~T ALL <br />HFCE.qf',ARY THFORMATTOM TS PROVIDED. A.~ SI'KIN AS AI.L REQUIREMENTS OF THE REVIEW <br />H~VE BEEH HF.T, Y~II WILL SE NOTTFIEO. <br /> <br />ilflNAI )l F. W(/(iDI FY~ MARTFiIq C(tIINTY NUTI D]'N[~ OFFT(.. AL / BY MBUL. L <br /> <br />................ FOR OFFICE U~E ONLY. THIS IS HOT A PERMIT .................. ZBHF: AR PROPFRTY LOe~TOR~ <br /> <br />SEPTIC REVIEW: OATE: ~OHIHC REVIE#: DATE: <br /> <br /> <br />