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MARION COUNTY <br />DEPT. OF BUILDING INSPECTION <br /> · Ssru~or Building #925 <br /> 220 High S~., N_E_ 2nd Ploor <br /> <br />  Salem, 0mgon 97301 <br /> R.H. 1NITHROW, BLDG. ADMINISTRATOR By: <br />~¥: ~ . 58~-~147 -- 588-5148 <br /> <br />Ty~ ~ITE EVALUAT~ ONLY Ta~ Lot No ~ ~ ~ ~ 0 -- Off o <br /> <br /> C. ' ' ' <br /> ...... Z-~, ~ ~ ' <br /> .. , A~dmss: .... - <br /> <br />Bldr. & No.'- Phone: , <br />Plans bY: <br /> <br />Lot No: 81k. No: ....... Sub <br /> <br />Water Supply: ....... <br />S~vage $/ta <br />Dis~I: ..... Eval: , <br /> <br /> ~ea of Bids; $~rles; _. <br /> Roof <br /> <br />H~ti~ <br />System; <br /> <br />aTU: ~ <br /> <br />Lot $iz~ner? ~ <br /> <br />Valuation: <br /> <br />Permit Fee: , . . <br /> <br />State Surcharge; <br /> <br />Plans Chk. Fee: <br /> <br />Septic Permit Fee: <br /> <br />Total Fees; <br /> <br />l~n <br /> <br />VALIO'ATiONS; <br />ZONING SEPTIC T~D ~, J:7 PLANS <br /> g~, ,~ .. ~y= ..... L ~ ~y: ....... <br /> <br />I a~r~ to butl~ordi~ to ~e ~ plan: 'a~ ~ffi~t~ng, ~ la~ of ¢0 Smze of 0~ ar ¢0 Orldnan~sofM~n <br />C~. Permit ~xpi¢o~ /{ ~rk nof commO~ with~o f~ days. I furh~ expr~ly warrant that I COmply with tho previewed= O~ ORS <br />~01.~ to 701. ~25 ~au~: <br />( ) I bm a ~i~r~ builder ~ ( ) ~e ~oriz~ r~po~nfa~i~ o~o r~i~or~ bo/Idex <br />( ) Tho ~k ~ill be pofform~ ~y a r~is~ builder <br />( j I am p~r~i~ ~ on o pfo~e~ I own or ~upy <br />{ ) 0~ (pl~ify) . . <br />REMARKS' ~ ~OTE, Th~s ~s not aran~ ~ ~m~lv ne~4nn tn h,Hla n. ~h~ <br /> parcel. Planning appmval and constructfon ~m~ts mast <br /> <br />I have red ¢i~ appleton in i~ ent/t~ a~ ca, ifF ~at the sa~ information is ~uo and corot ~ fho ~s~ of mF k~wl~g~ <br /> <br />PLEASE NOTE; Driveway and sidewalk inspections are required by Public Works: <br /> <br /> Other Permil~ required by thi~ dept: Plumbing ~ Electrical <br /> <br />~588-5038, <br /> <br /> <br />