Laserfiche WebLink
Received By; <br /> <br />C*ty ,, <br />Zoning Validation:,~-~/ <br /> <br />Date; ?- <br />BUILDING ~ MOBILE HOME <br /> <br />MARION COUNTY BUILDING INSPECTION <br />,~enator Bldg, NO. 22S <br />220 High Stn~rt NE <br />~lef¢~, Oregon 97301 <br /> <br /> Phone $88-5147 <br /> <br />City.,,.Setback Requirements; <br /> <br />Front; Rear: <br /> <br />Left Right <br />Side; S de: <br /> <br />PERMIT APPLICATION <br /> <br />Property Owner: <br /> <br />Job Address; <br /> <br />Subdivision: <br /> <br />Mobile Home Park: <br /> <br />Bite NO.: <br /> <br />Mailing Address' <br /> <br />Property Tax Lot No,: <br /> <br />Sp, ,#; <br /> <br />Cross Street: <br /> <br />Fleet SIC Zone: <br /> <br />Block; <br /> <br />Lot Depth: Acres: <br /> <br />Zone:/~%. Map; <br />Irreg, Lot; " Cornery~ <br /> <br /> actor <br /> Business Name and No.; <br /> <br /> ng near; <br /> <br />Type of Permit'. New: [] <br /> <br />Addition; [] <br /> <br />Relocation: [] <br /> <br />Phone; <br /> <br />Phone: <br /> <br />Demo; [~'¢" Tach. <br />Ccc. Chg.; [] Review: <br /> <br />Address: <br /> <br />Use of Building; <br /> <br />Height of Building: No, Stories; Sq, Ft, Main Floor; Sq, Ft, 2nd Floor; Sq, Fl, Garage; <br /> <br />Mobile Home Mobile Home # Bedrooms; Occupancy; Occupant Load; <br />Width: Length; <br /> <br /> RES ~ <br /> COM LJ <br /> <br />Other: .............. <br /> <br />water Su p~y? <br /> <br />Proposed Septic Installation; <br />Previous Site Evaluation #: <br /> T e of System; <br /> YP ....... <br /> <br />Test Holes Ready: <br />Will call when holes ready; <br /> <br />Proposed Bedrooms: <br /> <br />Existing Septic Systemr <br /> Existing Tank Size: <br /> E×lst~ Drainfield Length: <br /> Type of System: <br /> <br />Date Tank Pumped; Existing Bedrooms: <br /> <br />SIGNATURE OF APPLICAN <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br /> <br />VaJeatioc; <br /> <br />Bldg, Fee; $. <br />Mobile Home Fee: <br />Fleet Surcharge: <br />Zoning Surcharge; <br />Btate Burcharge: <br />Plans Check Fee: <br />Site Evaluation Fee; <br />Beptic Permit Fee; .................... <br />DEQ Surcharge: <br />Technical Review Fee: <br /> <br />Reinspection Fee: <br /> <br />Investigation Fee: <br /> <br />City Fee: <br /> <br />TOTAL FEE; <br /> <br />RECEIPT NO.: <br /> <br /> <br />