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Appl. Revd; <br /> <br />3Uly 14~77 // <br /> <br />Date: July 14~77 <br /> <br /> MARION COUNTY <br /> DEPT, OF BUILDING iNSPECTION <br /> Downtown Senator Building <br /> 220 H]gh St., N,E. 2nd Floor <br /> Salem, Oregon 97301 <br />R.~. WITHROW, BLDG, ADMINISTRATOR <br />588-6147 - 588-5148 <br /> <br />Permit No, ~__ <br /> <br /> Mobile Home &: septic <br />Type of Permit; <br /> <br />Owner; . Eugene Kelly <br />Bldr. & No,:. <br /> <br />Phone: 364-272~ <br />Phone; <br /> <br /> Tax Lot No: <br /> s,c./F Twnsbp.,gS..e XO <br /> -- AUmsville <br /> <br />Address: 5775 Sh~w Hwy. S~ 97325 <br /> <br />Address: <br /> <br />P~ans b',/: Phone; <br />p Pee Zone I Zone Chg. Part. I Cond, Use / %/erisnce <br />Use bf J]'~d§.: Mia Req. <br /> <br />Lot No: .Blk. No: Sub dy. <br /> <br /> well <br />Water Supply'. Vatuatlon: __ ,~ <br />Sewage Sept :C Fees. 10~76-26 <br />Disposal: _ Study: Permit Fee: <br /> <br /> 24 x 60 No. <br />Area of BIdg; Stories: State Surcharge: <br /> <br /> Roof <br />Basement: Type: Plato Chk. Fee: <br />Heating <br />System; __,, gas Septic Permit Fee: <br /> <br />BTU: Total Fees; <br /> <br />, T.~y~ of Co~nst. <br /> <br />Address; <br /> Fire Zone I Occupancy <br /> <br /> " Fr t/ ' <br /> Lot Size __j __Corner? __ <br /> <br />15.00 <br /> <br /> 2.25 <br /> <br />37.50 <br /> <br />56.75 <br /> <br />Ropt, .o: 0 ~ ,5> ~ <br /> <br />I agree to build eccordin9 to the submitted ~ end apeciflcptions./~le laws ofp~he State of Oregon and the Ordinances of Marion <br />Co,,,;ty- Perm/t expire, if work not cemme~'~w£'hin 120 d¢~. <br />SIGNATURE OF APPLICANT:~ <br /> <br />ZO~~ SEPT~ ~. ~ / PLANS // , / <br /> ' - ~A~s ~- / -} 'l- <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 588-B036 <br />Other permits required by this dept: Plumbing E~ Electrical [] <br /> <br /> <br />