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DATE/TIME : 07/29/99 ]1:38 <br />TYPE : SP <br /> <br />UGB: SITE: <br /> <br />ON-SITE APPLICATION <br /> ACTIVITY NO <br /> STATUS <br /> SE/SP APPLIED <br /> ISSUED <br /> TO EXPIRE <br /> <br />99-06178 <br />APPLIED <br />07/29/1999 <br />00/00/0000 <br />01/25/2000 <br /> <br /> LOCATUR: DB1N1BC O1/OU <br />WORK DESC : SS: AUTH/FLD REPL MFG W/ MFG CITY: MARION COUNTY <br /> <br />EXIST BEDROOMS~ 2 PROPOSED BEDROOMS : 4 ZONE: AR <br />EXIST EMPLOYEE: PROPOSED EMPLOYEES: MAP: 46R <br /> LAND USE: <br />SITE ADDRESS : <br /> 5943 SHAW HY SE AM <br /> <br />SUBDIVISION <br />TAX ACCOUNT <br /> <br />APPLICANT <br />ADDRESS <br /> <br /> LOT: BL: <br />56048-208 PARCEL: 1.26 AC <br /> <br />LONG DAVID DEQ INSTALLER: <br />PO BOX 3433 PHONE: <br /> <br /> SALEM, OR 97302 DEQ LICENSE: <br /> PHONE 588-0700 <br /> <br />OWNER KLEIN,JERRY <br />ADDRESS 5942 SHAW HY SE <br /> AUMSVILLE OR <br /> 97302 <br />PHONE : 749-2962 <br /> <br /> Units Description Fee <br /> 1 Authorization w/Field Visit 250.00 <br /> 1 OEQ Surcharge 30.00 <br /> <br />Assessed fees : 280.00 <br /> <br /> Adjustments : .00 <br /> Total fees : 280.00 <br />PAYEE: LONG DAVID Total payments: 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 BF~q~NTIFIED. <br /> <br />SIGNATURE OF APPLICANT ~ <br /> <br /> Marion County Building Inspection <br /> 3150 Lancaster Dr. N.E., Suite C Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:20 Phone: (503)588-5147 24-hr Inspection Line: (503)273-4427 <br /> <br /> <br />