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MARION COUNTY <br /> /? - DEPT. OF BUILDING INSPECTION <br /> ZejTJ/~/- ~ ,J,,~.., Senator Building ¢~ 225 <br />Appl, Revd; - ,t~'_/.~/~c~..,*~r*~ 220 High St., N,E. 2nd Floor <br /> ~,~ Salem, Oregon 97201 <br />By; ,, R.H. WITHROW, BLDG. ADMINISTRATOR <br /> 588-514,7 - 588-5148 <br /> <br />Date: <br /> <br />81dr. & No,: Phone: Address: <br /> <br />, Twnshp. ,, Rge <br /> <br />Plans by; Phone: Address: <br /> Map Page 1 Zone Zone Chg, _ Part. Cond. Use Variance Fire Zone Occupancy Type of Const. <br />Use of Bide': .I or NOocc.Bdrms.Ld: Setbacks:Min Req. From Sides Read <br /> <br />Lot Not .Big. Not , Sub dy. , LOt Size Corner? <br /> <br />Water Supply: Valuation: $ , <br />Sewage Site <br />Disposal; __ Evah Permit Fee: , <br /> <br />Area of Bide; Stories: State Sur r~e; .... , <br /> <br />Basement: __ Type; ~; <br />Heating <br />System: Septic Permit Fee: <br /> <br />BTU; Total Fees: .... <br /> <br />I agree to bu//d according to the submitted p/aris and ,specifications, the laws of the State of Oregon and the Ordinances of Marion <br /> <br />VAkIDATIO~S: <br />ZON I N G SEPTIC TAN K PLANS.~"~ <br /> <br /> REMARKS <br /> <br /> ,, ,.. ,~ = .~-~ ~ <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works; 588-5036 <br />Other permits required by this dept; Plumbing ~ Electrical ~ <br /> <br /> <br />