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Appl. Revd;: <br /> <br />By: <br /> <br />Cate:: 4/22/77 <br /> <br /> MARION COUNTY <br /> DEPT, OF BUILDING INSPECTION <br /> Downtown Senator Su[tdlng <br /> :220 High St,, N,E, 2nd Floor <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br /> <br />Permit No. ~ ......... <br /> <br />Type of Permit:: gepair septic c%rainfield .Tax Lot No;; <br /> <br /> kt. 1, Box 25~ ,~u~cora 97002 .. 10 <br />Address;; ~ See, __ <br /> J <br />Owner: L hil Hanson 678-53~.5 <br /> Phone:__ Address:: <br /> <br /> ~ lw <br />_Twnshp. ~.~Rge, <br /> <br />Bldr,, & No,;; Phone: Address;; <br /> <br />Plans by:: Phone: Address:: <br /> <br />UseD/Bid9 Min Req,, <br /> ~epair c~ainfield Setbacks:: <br /> <br /> Occupa_~c¥ [ Type of Const <br />Front ~.~gid es,,. Rear <br /> <br />Lot No;: BIk, No: Sub dy,, <br /> <br /> Well <br />Water Supply:; Valuation: <br />Sewage ~' ×isbi~ Fees, <br />Dlsposah: Study;; Permit Fee; <br /> <br /> No <br /> bedroom <br />Area of Bldg; " Stories;; State Surcharge: <br /> <br /> Roof <br />Basement;; Type: Plans Chk,, Fee:: <br />Heating <br />System:: <br /> <br />Septic Permit Fee: <br /> <br />BTU;; Total Fees:: <br /> <br />Rcpt. No: <br /> <br /> Lot Size__136 acrOScorner? <br /> <br />$ <br /> <br />25.00 <br /> <br />I agree to bo/Id according to the submitted plans and apec/f/~ef~oJ)a, fha laws of ¢he State of Oregon and the Ordinances of Marion <br />County. Permis expires if work not c~~~ <br />SIGNATURE OF APPLICANT;; %/~/ ~ ~ <br />vAlIDATIONS;; ~]d~ ~ -- <br /> <br /> REMARKS <br /> <br />PLEASE NOTE:: Driveway and sidewalk inspections are required by Public Works: 588-5036 <br />Other permits required by this dept:: Plumbing [] Electrical [] <br /> <br /> <br />