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' Y ~ Mend ely <br />AppL Revd: <br /> <br />_Date! Nov. 7, 77 <br /> <br /> MARION COUNTY <br />DEPT. OF BUILDING INSPECTION= <br /> Downtown Senator 8uildlng <br /> 220 High St., N,E. 2nd Floor <br /> Salem. Oregon 97301 <br /> WITHROW, BLDG. ADMINISTRATOR <br /> 588-5147 -- 588-5148 <br /> <br />Type of Permi't; mob;le home for farm labor & septic <br /> <br />^edress:; ~gr~_T~,.elde~ Dr. $~ Aumsv£].~e ........................ <br /> <br />~en3amin O, Belden P~one:_ 769-5527 <br /> <br /> Permit N <br /> <br /> By'- <br /> <br /> Da,e, <br /> <br /> s~me 97325 <br />Address: <br /> <br />81dr & No · Phone:__ <br /> <br />Plans by. Phone: <br />Ma~ Pege ~"~,e ~-hg~ P~r,. [ Cond..U~e <br /> <br />Lot No; .Slk. NO;_ Sub dy. <br /> <br />Address: ...... <br />Address: <br /> <br /> Veriar~ce I Fire Zone l Occupallcy I TVDe of CoAst <br /> <br />.................. Lot Size 11~ a~er? <br /> <br />w3ter Supply: well <br /> <br />D ~sposal :: _~L¢_ D I; £ c <br /> <br />Area of 81dg; 28 ~ 66 <br /> <br />Study; ............... no . . <br />No. <br />Stories: <br />Roof <br />Type:: <br /> <br />Valuation; $ <br />Permit Fee: [ $. 00 <br />State Surcharge:: .60 <br />Plans Chk. Fee: ......... <br />Septic Permit Fee; 75 <br />Total Fees: 90.60 <br />Rcpt. NO: /~ ' <br /> <br />I agree to build acool'ding to the submittad plans and ~peciffcetion~, the laws of the State of Ore, on and the Ordinances of Marion <br />Count/. Permit expires if work not.commenced ~fn 120, day~. ~'~ <br />SIGNATURE OF APPLICANT: ----g , ....... <br /> <br />VALrDATIONS; <br /> <br />~., <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: $88-5036 <br />Other permits requlred by this dept; Plumbing [~] Electrical [] <br /> <br /> <br />