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Appl Rood 6/1/87 :!~' ,Q ,3 : ','.;~20HighSt,.NE,,2ndFIoor <br /> Salem, Oregon 97301 <br />By City of Aumsvil~Ri0N COUNTY 588-5147 ~ 58~.5148 <br /> ~u.d~J~lGd~$?£C1,0N CODE-A-Phone 8::00 AM <br />Date <br /> <br />Permit No <br />By__ <br /> <br />Date <br /> <br /> - .. Picnic Shelter <br />Type of ~ermm ............ <br /> <br />Address:: Mill Creek bark <br /> <br /> Tax Lot No <br /> <br />Sec, .Twnshp .Rge <br /> <br />Owner City of Aumsville Phone::_ <br /> <br />Bldr & No::_Ossenkop Const. Phone;: <br /> <br />581-7122 <br /> <br />Address:: <br /> <br />Address, 1255 Boone Rd. Apt. 56, Salem <br /> <br />Plansby JMS Enqineerinq Phone::__585%5~78 ~Addreas:: 1810 Lana Ave NE, Suite ¢1 <br /> Map Page ]PUZ°ne ' Zone Change Part tend U~e variange/Adj FT/FD Occupancy Ti0~em <br /> <br /> Use of Bldg NO ed(ms Min Req Front J Sides Real <br /> Picnic shelter or Ccc I.d Setbacks <br /> <br />Lot No _BIk No:: ........ ,..Sub dy:: <br />Area of Bldg 2nd Base- <br />Main Fir 23~ Fir merit <br /> sq. ft. <br />Roof Type:: Truss/Stick <br />Heating Wood <br />System:: .Stove <br />Septic Tank New <br />Site Eval ......... Instal:: <br />Exist No <br />System Gels <br /> <br />,, , Lot Size:: Corner?. <br /> Total <br /> Area Valuation, $936.00 <br /> Bldg, Permit <br /> <br /> Height <br />Water <br />.Supply:: <br /> <br />VALIDATIONS <br />Zoning Mechanical <br /> <br />Septic Tack Pfens <br />Date .Date:: <br /> <br />I agree to build according to the submitted plans and specifications, the laws of the <br />State Of Oregon and the Ordinances of Marion County PERMIT EXPIRES IF WOF~K <br />NO T COMMENCED WI THiN 180 DA YS I further expressly warrant that I comply with <br /> <br />the prowslons of ORS 701005 to 701 125 because:' <br /> <br />( ) I am performing work on a property I own <br /> or occupy <br />( ) I am a registered builder OR ( ) the <br /> authorized representative of a <br /> registered builder <br /> <br /> by a registered builder <br />( ) Other (please specify) <br /> <br />REMARKS <br /> <br />Elect Fee:: <br /> <br />Mech, Fee <br /> <br />Plumb Fee <br />State <br /> (4%) <br />Surcharge <br /> <br />Plans Chk Fee:: <br />Septic Tank <br />Permit Fee, <br /> <br />DEQ Surcharge <br /> <br />TOTAL FEE <br />BLDG <br />RECEIPT NO <br />Driveway <br />Permit Fee <br />Site Plan <br />Review Fee <br />Public Works <br />Receipt No <br /> <br />t have read this application in its entirety and certlfy~at the stated informati~ue and correct to the best of my knowledge <br /> <br /> PLEASE NOTE Dr~;e~an~sidewalk inspection aredequired by Public Works:: 588-5036 <br /> Other permits required by this dept Plumbing [] Electrical E] Mechanical [] <br /> <br /> <br />