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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C · Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br /> ON-SITE APPLICATION <br />DATE/TINE : 1B/~1/97 16:37 ACTIVITY NO 77-~7865 <br />TYPE : SE STATUS APPLIED <br />OCCUPANCY : R-3 SE APPLIED 1~/~1/1977 <br />PAgE : ! SP APPLIED ~/~/~EB <br /> TO EXPIRE B3/3~/1998 <br /> <br />WORK DFSC : SE E/SMALL SYSTEM FOR FUTURE W'tR CLOSET IN SHOP <br /> <br />EXIST BEDROOMS: PROPOSED BEDROOMS : <br />FXIST EMPLOYEE= PROPOSED EMPLOYEES: <br /> <br />SiTE AODRESS : CITY: MARION COUNTY <br /> 12~8~ MAPLE LEAF CT NE AR <br /> <br />SUBDIVISION : MAPLE [.FAF <br /> <br />CROSS STREET : BOONES FERRY RD <br /> <br />PARCEL NUMBER : <br />PARCEL S~ZE : 3.50 AC <br /> <br />LOT: 1 B. OCK. 2 <br /> <br />OWNER : MCINTIRE Wild.lAM & KATHRYN <br />ADDRESS : 12786 MAPLE LEAF CT NE <br /> AURORA OR <br /> ~70]~ <br />PHONE : 58~-678-6236 <br /> <br />AU'EH AGENT <br /> Al)DRESS <br /> <br />JAMES GRIFFITNS EXCAVATING INC <br />PO BOX I1~6 <br /> <br /> CANBY~ OR <br /> PHONE : 283-8838 <br /> <br />DlilQ INS'rAI.I.ER : <br /> <br /> F Hr)N_ : <br /> ~ n~s Descriptiort , <br /> T ~ evaluation <br /> ] D[:Q Surcharge <br /> <br />DEQ LICENSE: <br /> <br />Fee <br /> <br />2?0.00 <br /> <br /> Assessed fees 328.00 <br /> Ad ~iustl,~ent s .08 <br /> 'Total fees 320.00 <br /> PAYFE: ,JAMES GRIFFITHS EXCAVATING INC To~l p~yments: 320.~8 <br /> M,INT[RE WILLIAM & KATHRYN Ba].ance due : <br /> <br /> THIS IS HOT A PE~IT. THIS APPLICATION MUST ~0 THR~GH A REVIEW PROCESS WHERE <br /> SOIL, FEASAOIL~TY AN~ INSTALLATION REQUIREHENTS ARE CHEC~E~ PRIOR TO THE ISSUANCE <br /> OF A PERHIT. IT I~ ~E RESP~SIOILITY OF THE APPLICANT TO ASSURE THAT ALL <br /> NECESSARY INFORHAT[ON IS PROVIDE~. AS SOON AS A~ ~EQUI~EHENTS OF THE REVIE~ <br /> HAVE ~EEN HET, YOU ~ILL 8E NOTIFIE~. <br /> <br /> SIGNATURE OF APPLICANT: <br /> <br />......... '-~-'--¢8~ ~[[IcE ~SE O~kY. T~I~ IS NOr A PER~IT ........ <br /> HAP: 5R ZONE: AR PROPERTY LOCATOR: 641W22CABl~BB <br /> <br /> LAND USE CASE HO: <br /> <br /> <br />