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Hecelvea'~y: __/,~ ~,~I_,. ,~ y,:;~ 1 \, MARION 'COUNTY BUILDING INSPECTION City Setback Requirements: <br />city g...to, - <br />Zoning Validation; ~%~ ;'¢ 2~ Hfoh St~ NE Front: ~ Rear'. <br /> ~ ~ ~-- Sa em, Oregon 97301 - , ~ .... <br /> <br /> '' ,'~ ~,' )~{' ~;~ ~Phone 4 30 RM - 8 00 A M -- <br /> MOB LE HOME SEPT C PERM T APPL CATION <br /> <br />Property Owner; <br />Mark an_d., Marilyn Schultz <br />Job Address; <br />21533 Liberty St. N.E. <br /> <br />Aurora, Oregon 97002 <br /> <br />Phone: <br />678-2689 <br /> <br />Mailing Address; <br /> 21533 Liberty St N.E., Aurora <br /> <br />Site No,; <br /> <br />Property Tax Lot No,: <br />90160--],80 <br /> <br />Cross Street; <br />US Hwy 99E <br />Fleet S/C Zone'. <br /> <br />Subdivision: Lot: Block; <br /> 3 <br />Mobile Home Park: Sp. ~¢; TOfel ¢/ Spaces; <br /> <br />Section; <br /> 12CD <br /> <br />Township; <br /> <br />Map; <br />12CDO41w <br /> <br />Lot Width; Lot Depth; Acres: irreg. Lot: Corner; <br />82.5 190 <br /> <br />Contractor Business Name and NO.: <br /> <br />Address: <br /> <br />Architect/Engineer: Phone: Address; <br /> <br />Type of Permit: New; [] Addition: [] Demo; [] Tach. Use of Building: <br /> <br />~'~',~5. - i~'~ ~-- Alter; LQ Relocation: [] Ccc. Chg.; [] Review: [] COM [] <br /> <br />Height of Suiiding; NO. Stories; Sq. Ft. Main Floor: Sq. Ft. 2nd Floor: Sq. Ft, Garage; Other: <br /> <br />Mobile Home Occupancy; Occupant Load: Water Supply: <br />Width; <br /> <br />Mobile Home <br />Length; <br /> <br />Cf Bedrooms; <br /> <br />Proposed Septic Installation; <br />Previous Site Evaluation ¢,; <br />Type of System: <br />Test HO~eS Ready; <br />Will call when holes ready; Proposed Bedrooms: <br /> <br />Existing Septic System: <br /> Existie~l Tank Size; <br /> Existing Drainfield L~en.g!h; <br /> Type of ~Sj. stem; <br /> <br />...... D,s!e Tank Pumped: /O/~...¢-~..~--~'_.~xlsting Bedrooms: <br /> <br /> The work will be performed by a registered builder, <br /> <br />OTHER PERMITB REQUIRED BY THIS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br />MC ~$-6 <br /> <br />Valuation; $.__ <br /> <br />Bldg, Fee; $.__ <br />Mobile Home Fee: <br />Fleet Surcharge: <br />Zoning Surcharge: <br />State Surcharge: <br />Plans Check Fee: <br />Site Evaluation Fee: <br />Septic Permit Fee; / D C,. ,C' ~_ <br />DEQ Surcharge: <br />Technical Review Fee: <br />Reinspection Fee; <br />Investigation Fee: <br />City Fee: "Z ~', ~ 0 <br />TOTAL FEE: / ~'. 0 0 <br />RECEIPT NO.: "~_.~3'~--" <br /> <br /> <br />