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Appl, R'cvd <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> 3180 Center St., N.E, <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br /> <br /> Permit Number <br /> <br />By;: <br /> <br />Bldr, & No,,:_,SC¢--~~-~p -- Phone:: Address;; <br /> <br />Plans by:: ..... Phone:: Address;; <br /> <br />Lot No:; BIk, No:: <br /> <br />Sub dv <br /> <br />Size of Lot:: .......... <br /> <br />Are~ of 81d~:: ...... <br /> <br />No of Stories., <br /> <br />Water Supply: <br /> <br />Corner?__ <br /> <br /> Min Req, Front Sides <br /> <br />fi/( Se, wage ,~, ~. Fees,, <br /> > D sposa: ~ Study7 <br /> <br /> Valuation;: $ .~'~'~ <br /> Permit Fee: ~' <br /> <br />Type of Const, <br /> <br />Rear <br /> <br />State Surcharge:;.,2'¢ ~7,j <br /> <br />Basemen[. Septic Permit Fee:: <br /> /1//,/ <br /> <br /> Rapt, No, <br /> <br />I aCree to build according to the submlt~d plans and specification~ of t~-~fa~ of Oregon and the Ordinances of Marion <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />VALIDATIONS: <br />ZONING ~ SEPTIC TANK <br />DaTe (~/¢ Date <br /> <br /> Submitted ~ wf~hou~ plans <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 [] <br /> <br /> <br />