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- ; '---¢~'- .~ ,~' I~.,ARION COUNTY BUILDING INSPECTION city Setback Requirements; <br />C ty .~ /~,'~":;k '<~, '~ ;. ~ -." ~ Senator Bl~g. NO. 225 <br />Zoning Validation; ~' ~'~<~;~ ~ ~' ~, ¥'" 2~0 High Strut NE Fro~t; ~ ~ Rear: <br /> ' ~ (',,~, , ~ ~ em. Or,on 97301 <br /> ~ ~% , ' ~ .~ Left / Right <br /> <br /> , ~qA . eS~A-Pbo,e 4:30 RM.' 8:00 A.M. / r <br /> Pro~erty~ner~ .1 , ,,, Phone: Mailing Ad~s~; <br /> <br />deb Address; <br /> <br />Site No.: Croas Street; <br /> Fleet S/C Zone; <br /> <br />Prej3erty Tax Lot No,; <br /> <br />Subdiyi,~ion; · ~ ' · ,, Block: <br />Mobile Home Park: Sp. ~'. <br /> <br />Section: ~ ] Township: <br />Lot Width'. ........ Lot Depth; <br /> <br />Zo,~/~4 Map; <br />,rreg~ Corne~,~ ~ <br /> <br />Total # Spaces; <br /> <br />C~o~traCtor Busines~Name ~nd No.: <br />Architect/Engineer; <br /> <br />Phone; <br /> <br />Address: <br /> <br />· e of Permlti I New: <br />_~,,~/~ ]] Alter: <br />Height of Building: <br /> <br />Mobile Home <br />Width: <br /> <br />Addition; ~ Demo: [] Tach. <br /> <br />Relocation; [] Ccc. Chg.: [] Review: [] <br /> <br />NO. Stories; <br /> / <br />Mobile Home <br />Length: <br /> <br />Sq. Ft. Main Floor; <br /> <br />Bedrooms; <br /> <br />Sq, Ft. 2nd Floor; <br /> <br />Occupancy: <br /> <br />Building: <br /> <br />Sq, Ft, Garage: <br /> <br />Occupant Load; <br /> <br />Other: <br /> <br />Water Supply: <br /> <br />RES ~ <br />GeM [] <br /> <br />Proposed Septic Installation: <br />Previous Site Evaluation #; <br /> <br />Type of System; <br />Test Holes Ready: <br /> <br />Will call when holes ready; Proposed Bedrooms: <br /> <br /> Existing Septic System; <br />__,6.~!sting Tank Size_;. <br /> Existin~ Drainfield Length: <br /> <br />Type .of System: <br /> <br />Bate Tank Pu~.p_ed; <br /> <br />Existing Bedrooms: <br /> <br /> '~ ) I have tead this applJcatlon in its enSrety and cenlfy that the stated information is <br /> true and correct to the best of my knowledge. <br /> ) I am performing work on a property I own or occupy. <br /> <br /> The work will be performed by a regis ered bu der. <br /> <br />'~SIGNATURE O F A p p LIC AN T ,~¢~r/~/¢~'~ <br />OTHER PERMITS REQUIRED BY THIS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br /> <br /> Valuation: <br /> <br />Bldg. Fee; <br /> <br />Mobile Home Fee: <br />Fleet Surcharge: <br />Zonlng Surcharge: <br />State Surcharge; <br />Plans Check Fee: <br />Site Evaluation Fee; <br />Septic Permit Fee; <br />BEQ Surcharge; <br />Technical Review Fee'. <br />Reinspection Fee: <br />Investigation Fee; <br />City Fee; <br /> <br />TOTAL FEE'. <br />RECEIPT NO.: <br /> <br /> <br />