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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Building 4~ 225 <br />Appl, Reval: 290 High St,, N,E, 2nd Floor Permit <br /> Salem, Oregon 97301 <br />By: ,~ R.H. WITHROW, BLDG. ADMINISTRATOR <br /> 588-5147 - 588-5148 <br /> 5:00 P.M.. ........... CODE-A-Phone 588.5373 ........... 8:00 A.M. Date: <br />Date: <br /> <br />Tyrol Permit; <br /> <br />Tax Lot No; <br /> <br />A~q?rr~' , $ . 3 31ns . 8~ge <br />Phone~ <br /> <br />Phone: Address: <br /> <br />Plans by: phone: .Add,ss: <br /> Zone Chg.. Part. Cond. Use Variance Fire Zone Occupency Tyce of Const. <br /> <br />Use of I~dg.: ' <br /> Sides <br /> . <br /> <br />Lot No: BIk. No: <br /> <br />Water Supply: .... <br />Sewage <br />Disposal: ~ <br /> <br />System: ..... I - ~ <br />~TU; ,, Total Fees: <br /> <br /> Sub dy. Lot Size <br /> <br />level: Permit Fee: <br />/, <br /> /L, <br /> <br />Rcpt. No: <br /> <br />ZONIN~i, k-~ SEPTIC TANK PLAN <br /> <br />I agree to build ~cord/~ to the sobm/tt~ plans and specifications, the la~ of the Etate of Or,on and the Oridnaoces of Marion <br />County. Per~/t ex~/re~ if work ~o~ commen~ed Within 120 days. I furhter expressly warrant that comply with the provisions of ORS <br />70Y.~5 rO 70L ~2~ ~ause; <br /> <br />( ) lamar~i~ter~bui/deror( ) theau~orizedrepremntatlveofar~/uter~bu/Ider <br />( ) The work will b9 pedormed by a r~i~er~ builder <br />[ ) / am p~form/~ ~rk on a ptoperCy / own or occcpy <br />( ) Other (please <br /> <br /> I / i ./ <br /> <br />/ ha~ read ~/~ epp//ca~/o~ /~ /~ ~ ~ cert/(~ that ~ ~ i~o~afion & <br /> <br /> PLEASE NO4E~hDri;ewaj an5 slde;a/k ,nspe~i;~s are requ~ by Public Works: 588'5036 , Other permits required by this dept: Plumbing <br /> <br /> <br />