Laserfiche WebLink
,.FOR .OFFICE USE ONLY <br /> <br />MARION COUNTY BUILDING INSPECTION <br />220 High St~ee! NE <br />~alem. OR 9B01 <br /> <br /> 8.~0 a.m.-4:30 p.ra. Phone 598.5147 <br /> God+A-Phone <br /> FAX 588-'794B <br /> <br />FOR OFFICE USE ONLY <br /> <br /> DWELLING/STRUCTURAL AND/OR SEPTIC PERMIT APPLICATION <br /> <br />1. Job Description <br /> <br /> R~IDI~NTIAL <br /> [ I NewSFD w/page [ ] <br /> <br /> u'eofa"~ms: Single family residence <br /> <br />2, Location of In~a[latlon <br /> <br />lob A~lw~ ..... Tax A~¢~ Nb C~s Stt~t ................................. <br /> 7821 Terrance Ln. 75060-050 Mill Creek Rd. <br /> Sim No. <br /> aumsville, Ore. <br />Subdiv~ ~ B~ <br />Terrance Subdivision 4 1 <br />Mob~ Hme Pa~ $~e ~ <br />NO <br /> <br />~ wum165 feet ~t~ Ac~ ~s.~ ~cr PavaeW~ [~ Sp~ { ) <br /> 0.89 ~m~ityWen [ ) Ci~ [ ) <br /> <br />3, Contractor Information 5; Fee Schedules <br /> <br />,Jose ana Beatrice <br />7821 T~rrance lm. aumsv~l±e, ure. <br /> <br /> unnyv~ew Rea± Estate <br />3396 Greentree Dr_ N.E_ Salem. Ore. 97305 <br />C~uac~rBus~ssN~me& Numar <br /> <br />Architect <br /> <br />Mailing Add~.ss & Pbe~e N~ ~ <br /> <br /> Septic Information (Check where applicable) <br /> <br />Propo~lNo. Bem: Exi~dngNo.]~-Am,~ns: 3 ~w~talhtion[~ <br />PmposrA S~t~ Ev~uafi~ <br /> <br />] Existing Site Evahad~ No,; <br /> <br />~ist~g Dra~t~d ~n~; T~ Si~ 1,000gal <br />DmTmk~st~mp~: ins~ll~ new 3/4/88 <br /> <br /> ] ~ am peffo~g ~ ~ a ~y [ own or <br /> ~fldar. <br /> <br />C <br /> <br />Valuatlom $.__ <br /> <br />SubtoM: $ <br /> <br />Subtotal; $___ <br /> <br />x$40= <br />Total: <br /> <br />Receipt: <br /> <br /> <br />