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BUILDING [] <br /> <br /> Job Address ~ <br /> ~"1"-' * I ~ ,.~ ~ . ~ 6/ J Property ex et o <br /> <br /> Subdivision ' A ~ / J <br /> <br />........ ........ _ <br /> Section:; ~ Township ( [ Range:: ~'/ [ Map ~ ~ T <br /> <br />' ~( ~' / ~ ] Acres:: <br /> <br />' Contracto~ Business Name and NO :: <br />Architect/Eng~eer . ,__ ~ " Phone <br /> <br /> Type of Permit New ~ ~dition ~ Demo ~ ~ech <br /> Alter, ~ Reliction ~ <br /> <br />Height of Buildin <br /> <br />Mobile Horg¢ <br />Width ~-{~.___ <br /> <br />MARION ~OUN'I:Y BUILDING INSPECTION Ic.!t~,.s~_~c_..~. Requiremem~s <br />Senat°r IBId9" N°' 22~220 High Str~ NE ~ront~ ~ar <br /> ~lem, Oregon 97301 ~eft ~ } Right <br /> Side::~ Side <br /> ~h~e ~88-5147 ~..~ ........................ <br /> <br /> MOBIbE HOME ~ SEPTIO ~ PERMIT APPblOATION <br /> <br />Proposed Septic installation <br />Previous Site Evaluation # <br /> <br />Type of System <br /> <br />Test Holes Heady <br /> <br />NO Stories:: '"Sq,, Ft Main Floor':; Sq Ft 2nd Floor:: <br /> <br />Mobile Ho.me ~,~ <br /> Occupa,ncy/¢- <br /> # he'd'rooms:: - <br /> <br />Exi~tin_¢. Tank Size:: _, <br /> <br /> ) Other <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT4 PUJMBING, MECHANICAl., ELECTRICAL <br /> <br />Fleet S/C Zone <br /> <br />Block '.¢~. __~_~ ...... <br /> <br /> Mobile Home Fee <br /> <br />O"Zoning Sl.lrcherge [ ~- ~' <br />~State Surcharge:: / -~-- <br />PlansCheck Fee:: / ~? ~'* <br /> <br /> Septic Permit Fee:: <br /> DEQ Surcharge <br /> ~eohnical Review F~e:: <br /> <br /> Investigation Fee <br /> <br /> TOTAL FEE .~?.~l <br /> RECEIPT NO ._ <br /> <br /> <br />