Laserfiche WebLink
H'eceived'By: ~ ~ ~ MARION COUNTY BUILDING INSPECTION <br />Z'~ning Valldatlon~~ 220 Hleh et~ NE <br /> <br /> BUlL ~'MOmLEHO~E~ ~EPTI~ ~ PEn~TAPPM~ATION <br /> <br />Tax Lot: <br />Sl,eNe.: ?£7 <br /> <br />Contract City; UGS; <br /> <br />Use of Building: __ ., <br /> <br />Mailing AddreSs: .... <br /> /3, <br /> <br />Width: Depth; <br /> <br />MIn. Reqd. Front: Right Rear: <br />Setbacks: <br /> <br />r ag, Lot: <br /> <br />Cor~': <br /> <br />Map: <br /> <br />Fleet S/C Zone: <br /> <br />~pe of Permit: <br /> <br />Contrac~;~r; <br /> <br />Home Builder's Registration No,; <br /> <br />'~N~ Addition: ~ Demo: [] Tech, J Useof Building; ~ RES ~ <br /> Alter: [] Relocation: [] Ccc. Chg.: [] Review: [] ~L~/~¢,//~ .~/~q,,/~,/ OOM ~ <br /> T Phone; ~ <br /> <br />Arch' ,act/Engineer: <br />Height of Building; <br /> <br />Mobile Home: <br /> <br />No, S,~ies; <br /> <br />Width: <br /> <br />Proposed Septic Installation: <br /> Previous Site Evaluation #: <br /> Type of System: <br /> Test Holes Heady: <br /> Will call when holes ready: <br /> <br />Existing Septic System; <br /> Existing Tank Size; <br /> Existing Drainfield Length'. <br /> Type of System: <br /> Date Tank Pumped: <br /> <br />Length: ¢ ' Water Supp~ <br /> <br />Valuation: <br /> <br />Address; <br />Sq, Ft, Garage; [ Other; <br /> <br />Bldg. Fee: <br /> <br />Mobile Home Fee: <br />Fleet Surcharge: <br />Zoning Surcharge: <br />State Surcharge; <br />Plans Check Fee: <br />Site 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 /> ~ Is true and correct to the best of my knowledge, <br /> <br /> a registered bu~lde~ <br /> <br />OTHER PERMITS REQUIRED BY THIS SEPT,: PLUMBING, MECHANICAL, ELEC'rRICAL <br /> <br /> <br />