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Zoning ?alidation / , <br /> <br />BUILDING <br /> <br />MARION COUNTY BUILDING INSPECTION <br />Senator Bidg,, NO,, 225 <br />220 High ,~treet NE <br /> Salem= Oregon 97301 <br /> <br /> Phone 5se-s147 <br /> Code-A-Phone 4:30 P,M- - 8:00 A,M, <br /> <br /> MOBILE HOME [] SEPTIC [] <br /> <br />City Betbsck Requirements <br />Front ~, <br /> Left Right <br /> Side /2'~ ' Side <br /> <br />Rear <br /> <br />PERMIT APPLICATION <br /> <br />Pt..gEar ty Owner <br /> <br />Job Address <br /> <br />Subdivision <br /> <br />Mo~ile Rome Park <br /> <br />Section - Town~ {¢%_~¢/ <br />,~- Range <br /> <br />Lot Width Lot Depth Acres <br /> <br />Phone:: <br />?/~ . I :~ 7. <br /> <br />Mailing Address <br /> <br /> Property Tax Lot Nb :: <br />5 <br /> Lot / <br /> <br />Sp # <br /> <br />Cross Streep <br /> <br />Fleet S/C Zone <br /> <br />Block <br /> <br />Total # Spaces:: <br /> <br />Con_tractor Business Name and NO <br />~Ar~?hit oct ¢ E ngineer <br /> <br /> - <br /> <br />Height of Building <br /> <br />Mobile Home <br />Width <br /> <br />New:: ~ Addition <br />Alter II Relegation <br /> <br /> No Stories <br /> / <br />-I~-obile Hams <br />Length:: <br /> <br />Phone;: <br /> <br />~ Demo:: [] <br /> <br />[] 0¢,¢, Chg:: [] <br /> <br />ISq ~t Main Floor <br /># Bedrooms <br /> <br />Tsch <br />Review [] <br /> <br />Sq Ft 2nd Floor <br /> <br />Occupancy <br /> <br />Use of Building:: RES ~ ~''''' <br />~,¢ ¢.-/¢G COM [] <br />Sq Ft Garage l-~tner ........... <br /> <br />Occupant Load I~ Suppl~ <br /> L__ <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 <br /> <br />Existing Septic System <br />Existing Tank Size:: <br /> <br /> Existing Orainfield Lencjth <br />_Tyjpe, 9!, ,~y,~t?:: ,,, <br /> Date Tank Pumped <br /> <br />Existing Bedrooms <br /> <br /> L~he work will be performed by a registered builder <br /> <br /> ~-) I agree to build according to tMe submitted glans and specifications, the I~ws of <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT,: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br /> <br />Bldg Fee $ <br />Mobile Home Fee <br />Fleet Surcharge <br />Zoning Surcharge <br />State Suroharge <br />Plans Check Fee <br />Site Evaluation Fee <br />Septic Permit Fee <br />DEQ Surcharge <br />Technical Review Fee:: <br />Reinspeetion Fee <br /> <br />Investigation Fee <br />City Fee ~;'~/ '~' ''~ <br />TOTAL FEE <br />RECEIPT NO .... <br /> <br /> <br />