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ON-SITE APPLICATION <br /> DATE/TIME : 03/11/99 10:48 ACTIVITY NO 99-01747 <br /> TYPE : SP STATUS APPLIED <br /> SE/SP APPLIED 02/11/1999 <br /> UGB: SITE: ISSUED 00/00/0000 <br /> TO EXPIRE 09/07/1999 <br /> <br /> WORK DESC : SS:AUTH W/VISIT FOR A MANF DWELL REPLACEMENT CITY: MARION COUNTY <br /> <br /> EXIST BEDROOMS: 2 PROPOSED BEDROOMS : 3 ZONE: EFU <br /> EXIST EMPLOYEE: PROPOSED EMPLOYEES~ MAP~ 5 <br /> LAND USE: <br /> SITE ADDRESS : <br /> 12737 DONALD LOOP RD NE AR <br /> <br />· SUBDIVISION LOT: BL: <br />TAX ACCOUNT 40929-000 PARCEL: .26 AC <br /> <br /> APPLICANT LOPEZ.JOE & CYNTHIA DEQ INSTALLER: <br /> ADDRESS 12727 DONALD LP RD PHONE: <br /> AURORA OR <br /> 97002 DEQ LICENSE: <br /> PHONE 502 678-5190 <br /> <br /> OWNER LOPEZ.JOE A & CYNTHIA K <br /> ADDRESS 12737 DONALD LOOP RD <br /> AUROP~q, OR <br /> <br /> PHONE 503 678-5190 <br /> <br /> Un, ts Description Fee <br /> I Authorization w/F~eld V~s~t 250.00 <br /> 1 DEQ Surcharge 20.00 <br /> <br />Assessed fees : 280.00 <br /> <br /> Adjustments : .00 <br /> Total fees : 280.00 <br /> PAYEE: LOPEZ.JOE & CYNTHIA Total pa~qnents: 280.00 <br /> Balance due : .00 <br /> <br /> THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE <br /> SOIL. FEASABILITY AND INSTALLATION REQUIREMENTS ARE CHECKED PRIOR TO THE ISSUANCE <br /> OF A PERMIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL <br /> NECESSARY INFORMATION IS PROVIDED. AS SOON AS ALL REQUIREMENTS OF THE REVIEW <br /> HAVE BEEN MET. YOU WILL BE NOTIFIED. F~ <br /> SIGNATURE OFAPPLICANT: ,f'~'~-~ ~ <br /> DONALD E. WOODLEY, MARIO BER~._~ <br /> Marion County Building Inspection ~ <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 /> <br />