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Received By ~/~/ <br />City <br />Zoning Validation <br /> <br />BUILDING <br /> <br />MARION COUNTY BUILDING INSPECTION <br />Senator EIIdg, No,, 225 <br />220 High StOat NE <br /> Salem~ Oregon 97501 <br /> <br /> Phone 588-5147 <br /> Code-A-Phone 4:$0 RM, - 8::00 AM <br /> <br /> MOBILE HOME [] SEPTIC [] , <br /> <br />City Setback~Requireme~n!s <br /> <br />Left <br />Bide <br /> <br />PERMIT APPLICATION <br /> <br />'o rty O r <br /> <br />Job Address <br />¢¢% 9 ¢'~,~ /¢~ ~'~/ //~-~ Property Tax Lot No:: <br />Subdivision Lot <br /> <br />Mobile Home Park Sp # <br />Section Towns~hi~ ;'one Map:: <br /> <br />M 'ling Address:: <br /> <br /> Cross Street <br /> <br />Block <br /> <br />Total :¢ Spaces:: <br /> <br />Lot Width:: <br /> <br />Lot Depth:: ~ -~,C~- LOt Corner <br /> <br />entractor Business Name and No <br />A. rshi~-~TE ng'~-r~ <br /> <br />Phone;: <br /> <br />Phone <br /> <br /> Type of Permit New L1;],-'~'' Addition [] Dem~:~ ~ Tach <br />~..¢,¢l-Yl,'~'/'~l~/~/~.e4-'~ Alter [] Relocation ~ Ccc Ch9 [] Review:: [] <br /> <br />Height of Building <br /> <br />Mobile Home <br />Width:: <br /> <br />NO Stories:: / Sq, Ft, Main Floor:: Sq Ft 2nd Floor <br /> <br />Mobile Home # Bedrooms:; Occupancy <br />Length ~,~ <br /> <br />Proposed Septic Installation <br /> Previous Site Evaluation # <br /> <br />Type of System <br /> <br />Test Holes Ready:; <br /> <br />Will call when hoiee ready:: <br /> <br />Proposed Bedrooms:: <br /> <br />Existing Septic System <br />Existing Tank Size:: <br /> <br /> Existin~Dr_a n e d Length <br />__T~pe of System <br /> Date Tank Pumped <br /> <br />Bxisting Bedrooms <br /> <br />OTHBR PERMITS REQUIRED lElY THIS DEPT,: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br /> <br />Use ~i Building RES LI,J~ <br />q <br /> <br />Occupant Load <br /> <br />Valuation <br /> <br />Bldg Fee <br /> <br />Mobile Home Fee <br /> <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 />Reinspe~ion Fee <br />Investigation Fee:: _ <br /> <br /> <br />