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Received Sy <br /> <br />City <br />Zoning Validation:: ..... <br /> <br />BUILDING [] <br /> <br />MARION COUNTY BUILDING INSPECTION <br />Senator Bldg. NO. 225 <br />220 High Street NE <br /> Salem~ Oregon 97301 <br /> <br /> Phone 588-5147 <br /> Code-A. Phone 4:;30 P,M. - 8:00 A,,M. <br /> <br /> MOBILE HOME [] SEPTIC [] <br /> <br />L Side Side <br /> <br />PERMIT APPLICATION <br /> <br /> Property Owner <br />Bob R. Lankford <br /> <br /> Job Address:: <br />11692 Warbler Lane <br />Aurora, Oregon 97002 <br /> <br /> Subdivision <br />Century Meadows Phase Four <br /> <br />Mobile Home Perk <br /> <br />Section <br /> <br />Lot Width:: <br /> <br />Phone <br />692-5513 <br /> <br />Site NO:: <br /> <br />Mailing Address <br />6645 SW Nybe <br /> <br />Property Tax Lot No <br /> <br />Lot:: <br /> 10&11 <br /> <br /> Sp # <br /> <br />Township I Range:: t~'&; Map:: <br />Lot Bepth Acres:: ~Treg, Lot:; Corner' <br /> <br />:~. __Tualatin Or <br /> Cross Street <br /> <br /> Fleet SfC Zone <br /> <br /> Block <br /> 19 <br /> ~oial # Spaces <br /> <br /> Contractor Business Name and NO <br /> <br />~ilbur Wi 1 s_Qn ...... <br /> Architect/Engineer:: <br /> <br />Address <br /> <br />AddreSS: <br /> <br />Type of Permit New:; [] Addition [~ Demo [] Tach Use of Building RES rq <br /> Alter [] Relocation:; L~ Ccc Chg [] Review [~ COM ~ <br /> <br />Height of Building:: No Stories:: Sq, Ft,, Main Floor Sq Ft 2nd Floor Sq, Ft Garage <br /> <br />Mobile Home <br />Width 28 <br /> <br />Mobile Home <br />Length 52 <br /> <br />Bedrooms <br /> 3 <br /> <br />Occupancy <br /> <br />Occupant Load <br /> <br />Other <br /> <br />Water <br /> Supply <br /> <br />Proposed Septic Installation <br /> Previous Site Evaluation # <br />.T~pe of System <br />Test Holes Ready:: <br />Will call when holes ready Proposed Bedrooms <br />Existing Septic System <br />Existing Tank Size <br /> <br />Existing Drainfield Length ,,, <br />Type of System:; <br /> <br />Oate Tank Pumped <br /> <br />Existin.g. Bedrooms <br /> <br /> ) I have read this application in its entirety and certify that the stated information is <br /> <br /> X ) J am a registered builder OR ( } the authorized representative of a registered builder 47019 <br /> <br />OTHER PERMITS REQ II~ED BY THIS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br /> <br />Valuation $ <br /> <br />Bldg Fee $_ <br />Mobile Home Fee <br />Fleet Surcharge <br />Zoning Surcharge:: <br />State Surcharge <br />Plans Check Fee:: <br />Site Evaluation Fee <br />Septic Permit Fee <br />DEQ Surcharge <br />Technical Review Fee <br />Reinspection Fee <br />Investigation Fee <br />City Fee <br />TOTAL FEE ....... <br />RECEIPT NO:: <br /> <br /> <br />