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FO'R OFFiC~US~_~L¥
<br />Received B~; ~- / ¥ ~
<br />Zoniqg Validation ~
<br />Da~: ~
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<br /> 220 Hish St~ct NE U ~
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<br />8:00 ~m. - 4:30 pm ~oa~ 588-5147
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<br /> sss. ns BUILDING
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<br />~tractor Infnrmati,
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<br />I~lomm~cJal (DSF I D~lv ~W~e FIow~
<br />$ te 13valuation~ fi~t ~000 ~1. DgF 24~,~0 20.~
<br />S ~By~ ua o~t ca. ~dL 500 ~1. DS?, 75.00 20.~/m
<br />ConstructiOn & Repair Pe~i~: ::
<br />smnda~ sy~m less th~lIl000 ~1 DSF 24~i00 ....10100
<br />Smnda~ ~yatem m~l~ man 1000 ~[- DSF:
<br />$2~00 + $l~,,~a~h ~dl, 500 ~1, DS~ 10.00
<br />Gray Wa~r Wasm D s~o,~.,,~mp 120.00 , :,.~,~9.
<br />~olding Tank . 2~.00, 10,00
<br />Redundant Sys~m 245,00 l~.,~p
<br />, Stee~,~loge 245.00 10,00
<br />Plan Revi~ .........
<br /> >600 ~al, DSF,< 1001 gal DSF 100,00 .00
<br /> (For,~,~.~ddltlonal ~00 gal. DSF 25,00 .~0
<br /> Alkmtlons 24~.00 10.00
<br /> Ann~ ~v8 .~fio~ Of~lllS~m ~0,00 ~0.00
<br /> ~mper Track In~eCtibn, ea. ~dl, ~Ak~ ' if,on ,oo
<br /> ~het
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<br />Residential Single Family I s
<br />Site ]~yal0~!iollt firg lot 2451,00 20,00
<br />Cappl,n~ Fill 415.00 , ~.00
<br />~ay:W~r Disposal sump 120160 10~00
<br />Alt~i~n' 245,00 10,00
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<br />~p~K. ~nor (rank) 7Si00 10.00
<br />~nstm~on Pe~t ~n~a~ (~cld Visit} 150.00 I0.00
<br />Autho~ion Notic{ ~iel~ yi~[~) 150.00 10.00
<br />Annu~ ,~y~,~o~Alte restive Sy~m 150,00 .00
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<br />I agree to install acco~i~g to thc submitted plans and specifict/fi'6ns, the laws~
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<br /> o f he Stat~ of Oregon and the o~ na~¢es o£Madon County
<br />(Ivlad~ if Appllciblc to this Application) ,: ~~ ~.
<br />() Test Hoi~s am ~g l'
<br />( ) I will call when Te~ Holes ~g
<br />~i am peffo~ing work off apmp~ I o~ oroccupy N~E ~P~IC~l(~ease print): /
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<br />( )O,1,,, . . ~ ~ fi S~ OF ~PLiC~;, ~
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