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c,ty , <br />' Zoning Validation; ~ <br /> <br /> BUILDING [] MOBILE HOME [] ~,~r'/~J~~ ,leD~r,?,,-,,,~CJPlBI~IT APPLICATION <br />Pro ,pe~'t y Owner: ................Phone; ~ ~A~s; , , <br /> <br /> ~. ~ ~ ......... ~p., ~: ..... ~ot¢ ~,.~¢~ ,, <br /> <br />Section:I Townslip~~' Range:~/ ZO.L~ Map: <br /> <br />Lot Width~ ~ D~; ~ Adre~ ~ Irreg. LO~ Comer; <br /> <br />I Contractor Bustnee$ Nome and NO.: 7 .I Phone: / Address; <br />IArchltect/~ngineei: U ' ' Phone; " Address: <br /> <br />Heigh;~ of Building: <br /> <br />Mobile H <br />Width; ~ <br /> <br />E] Addition: rq Demo; [] Tach. <br />~"" Relocation: E] Occ, Chg.; I~ Review: [] <br /> <br />NO, Stories: [ Sq, Ft, Main Floor; 1 Sq. Fi, 2nd Floor: <br />Mobile Home I ~¢ Bedr, odms; I Occupancy: <br /> <br />Use of Building; <br /> <br />RES <br /> <br />COM <br /> <br />Proposed Septic Installation: <br />Previous Site Evaluation #: <br /> <br /> Type of System; <br /> Test Holes Ready: <br /> Will call when holes r~,.dy.; Prepoeed Bedroome; <br /> Existing Septic System: <br /> Exietin(I Tank Size; 1 <br /> Existing Drainfield Length: ~,~ <br /> <br />~ I h~vo road this appli~tion in i~ entirety and car ti~y th*t the dated inter mation ig <br /> <br /> agree to b~ild acceding to the ~ubmi~ed plans and specifi~tions, the laws of <br /> the s~te of Oregon and the or encee of Marion County. <br /> <br />~I~NATUR~ OF APPLICA = A ~ ,~./ ~,, <br /> <br />~HER PERMITS REQUIRED ~Y THIS DEPT.: P~MBING, MECHAniCAL, ELECTRICAL <br /> <br />Bldg. Fee; <br /> <br />Mobile Home Fee: <br />Fleet Surcharge: <br />Zoning Surcharge: <br />State Surcharge; <br />Plans Cheek Fee; <br />Bite Evaluation Fee: <br />Septic Permit Fee: <br />DEQ Surcharge; <br />Technical Review Fee: <br />Reinspection Fee: <br />Investigation Fee: <br />City Fee; <br /> <br />TOTAL FEE: <br />RECEIPT NO.: <br /> <br /> <br />