Laserfiche WebLink
CR Salem, Oregon 97301 <br /> By:: Patty <br />By;: 588-5147 -- 588-5148 <br /> ~:~- 5-20-86 5::00 P,,M .................... CODE-A-Phone 8,00 A.M 6-9-86 <br />Date:: Date:: <br /> <br />Type of Permit, SITE EVALUATION ONLY _Tax Lot No,,: <br />Address:: / ~ ~' O q E, HLEN RD N~g AURO~ Sec..:: 11 _Twnshp:: 45 Rge :: 1~ <br /> <br />Owner:; SUSIE M. ECKERSON .Phone' 620-2130 Address:: PO ROX 433 AURORA 97002 <br /> <br />Bldr & No: same Phone:: Address:: <br /> <br />Plans by:: .Phone: Address: <br /> M~,~gO 1/~k Zone OhangeI ~L2~ Cond Use Variance/Adj I FT/FD [ Occupancy [ Type of Const <br /> or Ccc Ld, 4 Setbacks:: <br /> <br />LotNo' RIk Nor Sub dv:: I otSize 2 AC <br />Area of Bldg 2nd Base- Total <br />Main Fir,,', _Fir: ment::. Ares:_ Valuation:: <br /> Bldg, Permit <br />Roof Type: __ Truss/Stick: Height_ Fee:: (+ 5%) <br />Heating Wood Water <br />System;: Stove:: Supply, Elect, Fee <br />Septic Tank New <br />Site Eval,; Instal,,:: Mech,, Fee:; <br />Exist.. No <br /> · ,T~7~TE' Th~S dcos not ~ :~:t or imply perml~¢01% t~. <br />System'. <br /> <br /> be~[oze bu~d~r.~3 Or soptic Lrtstc~ltc.'tionS~r~Q~ge. (4%) <br /> Mechanical:: <br /> Plans Chk Fee:: <br /> Septic Tank <br /> Permit Fee:: <br /> <br />VALIDATIONS' <br />Zoning:: <br />Date:: ~-'"--r/'~ ~-- Date <br />Septic T a r~'- /.~_~ Plans:: <br />Date:: __.J~-~.! ~(~/'/(2 ~,~(Jf,¢' Date <br /> <br />I agree to buitd according to the submitted plans and apecihcations, the laws of the <br />State of Oregon and the Ordinances of Mar¢on County. PERMIT EXPIRES IF WORK <br />NO T COMMENCED WI THIN 180 DA YS, I further expressly warrant that I comply with <br />the provisions of ORS 701.005 to 701 125 because: <br /> <br />( ) I am performing work on a property I own ( ) The work will be performed <br /> or occupy by a registered builder <br />( ) I am a registered builder OR ( ) the ( ) Other (please specify) <br /> authorized representative of a <br /> <br />Corner? <br /> <br />140. O0 <br /> <br /> 15.00 <br />DEQ Surcharge:: ................... <br /> <br />TOTAL FEE' t$5.00 <br />BLDG <br />RECEIPT NO,:: <br />Driveway <br />Permit Fee:: <br />Site Plan <br />Review Fee.. <br />Public Works <br />Receipt No;: <br /> <br />REMARKS <br /> <br />I have read this application in its entirety and certify that the stated information ie true and correct to the best of my knowledge <br />SlGNATUREOFAPPLICANT~2~-~~' t~.` .~:2~ <br /> PLEASE NOTE Driveway and sidewalk inspection are required by Public Works;: 588-5036 <br /> <br /> Other permits required by this clapt: Plumbing ¢1 Electrical ~ Mechanical E) <br /> <br /> <br />