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MAR[ON COUNTY <br /> DEPT. ~F BUILDING INSPECTION <br />Appl F~ec 220 High St,, N E, 2nd Floor <br /> Salem= Oregon 97301 <br /> ,¢,,,~ ' ?:' 7 588-5147 -- 588-5148 <br /> COUNT,,5 00::¥ PM CODE-A-Phone 800AM <br />es. Lo.,_ 6/1/8 ?~/IARI0 N <br /> <br />Type of Permit <br /> <br />Address ~[[ C=eek ~a=k <br /> <br />Owner ~_.C_i~t~. Of Aumsville <br /> <br /> Phone <br />BIdr & NO Os,senkop Const, ,Phone <br /> <br />Plans by JMS Engineering Phone;: <br /> Zone Change Part Cond Use <br /> <br /> U,~e of 8,dg oNrOoBcdcr~; <br /> Picnic Shelter <br /> <br />749-2030 <br /> <br />581-7122 <br />585-5578 <br /> <br />Date:: <br /> <br />..... Tax Lot No:: .... <br /> <br />Sec __Twnshp :: J~ge <br /> <br /> 595 Main St., Aumsville <br />Address;: <br /> <br /> 1255 Boone Rd. Apt 56, Salem <br />Address' <br /> <br />Address:: 1810 Lane Ave NE, Suite ~I <br /> ~atem <br /> <br />Front Sides I ........ ~ ' <br /> <br />Lot No BIk No' <br />Area of Bldg 2nd <br />Main Fir ~ 1 8.Fir:: <br /> sA- 'Ct:. <br />Root Type Truss/Stick;; <br />Heating Wood <br />System Stove <br />Septic Tank New <br />Site Eval Instal <br />Exist No, <br />System:: ................................. Gals :: _ <br /> <br />Sub dy:: <br />Base- Total <br />.ment: Area' __ <br /> <br />Height,,,. <br /> <br />VALIDATIONS <br />Zoning Mechanical <br />Date:: ¢///t,./~-? ~ Date <br />Septic Ten~ Plane <br />Date Date <br /> <br />Water <br />Supply <br /> <br />I agree to build according to the submitted plans and apecfflcationa, the laws of the <br />State of Oregon and the Ordinances of Marion County PERMIT EXPIRES IF WORK <br />NOT COMMENCED WITHIN 180 DA YS I further expressly warrant that I comply with <br /> <br />( Cc]The work will be performed <br /> by a regiatered builder <br />( ) Other (please specify) <br /> <br />the prOwaions of ORS 701005 tO 701 125 because: <br /> <br />Valuation 1672.00 <br /> <br />Bldg Permit <br /> <br />Elect, Fee <br /> <br />Mech Fee:: <br /> <br />Plumb Fee, <br />State <br />Surcharge (4%) <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 /> regiatered builder <br /> <br />Plans Chk,, Fee <br />Septic Tank <br />O..,~,,¢r m it Fee <br /> DEQ Surcharge <br /> <br /> TOTAL FEE:: <br /> BLDG <br /> RECEIPT NO:: <br /> Driveway <br /> Permit <br /> Site Plan <br /> Review Fee <br /> Public Works <br /> Receipt No:: <br /> <br />REMARKS:: <br /> <br />I have read thia application in its entirety and certify that the~ stated, information ia true and correct to the beat of my know/edge <br /> <br /> PLEASE NOTE Drive&and sidewalk inspection ar;requ~red'b/y'y Pub,,c Works 588-5036 <br /> <br /> Other required by _~J.u~'~ing _El ~le~al B Meoh~ ~.-- <br /> <br /> <br />