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r Bldg. No. 225 <br /> <br /> Oregon 97301 <br /> <br />I.~it_y. Setback Requirements <br /> Front:: '~¢~_Rear <br /> Left <br /> <br />Job Address:: <br /> <br />Subdivision:: <br /> <br />' Mol~il~-~lome Park <br /> <br />Site NO,:: <br /> <br />PERMIT APPLICATION <br /> <br />Property Tax Lot NO:: <br /> ..<d 75-- 7 <br /> <br />Lot:: <br /> <br />Sectfon <br /> <br />Township <br /> <br />Range <br /> <br />Map <br /> <br />Sp ¢ <br /> <br />Lot Width Lot Depth Acres:: Corner <br /> <br />Irr~g~ Lot;: <br /> <br />' Cr~ Street:: <br /> <br />Fleet S/C Zone:: <br /> <br />Block <br /> <br />Total # Spaces <br /> <br />Contractor Business Name and No ~ ~ ~' Phone <br /> <br />Type of Permit <br /> <br />Height of Building <br /> <br />Mobile Home <br />Width <br /> <br />"New:: LLd~''''' Add~bon <br /> <br /> Alter L~ Relocation <br /> <br /> NO - ~t~riaS <br /> / <br /> <br />Mobile Home <br />Length <br /> <br />L~ Demo [] Tach <br /> <br />Lq eec Chg :: [J Review <br /> <br />Bq Ft Main Floor <br /> <br />Bedrooms <br /> <br />Sq Ft 2nd Floor <br /> <br />Occupancy <br /> <br />Proposed Septic Installation:: <br /> Previous Site Evaluation <br /> Type of System <br /> <br /> Test Holes Ready <br /> Will call when holes ready <br /> Ex~sting Septic System <br /> Existing Tank Size <br /> <br />_ Ex_~sting Drainfield Length <br /> Type of System <br /> <br />Proposed Bedrooms <br /> <br />Date Tank Pumped <br /> <br />Existing Bedrooms <br /> <br />RevMCOTHER 15-612/8/PERMITS REQUIRED ~ CTRICAL <br /> <br />Use of Bui'iding <br /> <br />Sq Ft Garage <br />Occupant Load <br /> <br />Valuation <br /> <br />Bldg Fee <br /> <br />Mobile Home Fee <br />Fleet Surcharge <br />~oning Surcharge <br />State Surcharge <br />Plans Check Fee <br />Site Evaluabon Fee <br />Septic Permit Fee <br />DEQ Surcharge <br />Technical Review Fee <br />Reinspection ~ee <br />Investigation Fee <br /> <br />City Fee <br /> <br />TOTAL FEB <br />RECEIPT NO <br /> <br />Other <br /> <br />RES [] <br /> <br />COM <br /> <br /> <br />