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.MARION COUNTY <br /> <br /> pl. Re~: ~da7 ~0 High ~.. N.B. ~d FI~r <br />-~ ~1~. OffigOn g7~1 <br /> <br />By: ~ R.H. Wi~ROW. BL~. A~INI~RATOR <br /> <br /> ~/~ ~/~0 <br /> <br />Type of Permit; <br /> <br />Owner: 1,'~'ance,.~. K~ll~n~e~'5 Phone-' 769-2605 <br /> <br /> Tax Lot No. <br /> ..Sec. 1 Twin, bp. ~ge, <br /> <br /> Aum~v~Ile 97325 <br />Addre~:~qm~v~j[ l · . . ...... <br /> <br />pl~n~ by: Phone: <br />0'"'"'"'" .... <br /> <br />LOt NO: 8Ik. No: <br /> <br />Sub dv ........ <br /> <br />LotSize ~-& A~w.* Corner? <br /> <br />Water Supply; w~l 1 <br />Sewage <br />Disl;:m~ah ~ E'vah <br /> N,o,, <br />Area of Bldg; <br /> <br />System: <br /> <br />BTU: <br /> <br />valuation'. ~ <br /> <br /> ST ?A Permit Fee: 35.Ck0 <br /> <br /> [ .~0 <br /> $~orie$: State Surcharge: ....... <br /> <br /> R~f <br /> TY~: Pl~ ~k. Fee: <br /> ~ptio~ 60~O0 <br /> ~ T~I F~: 76.b0 <br /> <br />VALllDATIONS: ...... PLANS *~ <br />ZONING ~ SE~IC T~ ~ <br /> I ~ <br /> <br />I agre~ to build ~COrd/l~ to ~he submitted 1~1~ ~ ~tfi~t~. <br />~nW_ P~mit exp~e8 ff ~k not co~e~ w~b/~ ~ days. I <br />701.~5 tO 701.126 ~: <br /> <br />( ) The ~k will ~ ~ by a r~i~=~ buEd~ <br />( / I om ~fo~i~ ~fk on a ~ I O~ Or ~upy <br /> <br />I have ~#ad ~hls application in i~ e~t/~ty at~d certify ~hat ~e stated info~m~rlOl~ N frue a~d correct to the b~t of my k~owladga_ <br /> <br />PLEASE NOTE_' IDrtvewey and $icleW~li~ in~oeotlons are ~uirad by Public Work~: <br /> Oth~ permits required by this dept: Plumbing [] Electric~l <br /> <br /> <br />