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Appl,, R'evd:: dond [f <br /> <br />Date;; <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Downtown Senator Building <br /> 220 High St,, N.E. 2nd Floor <br /> Salem, Oregon 97301 <br />R.H. WITHROW, BLDG. ADMINISTRATOR <br />588-§147 - $88-5148 <br /> <br />Address;; <br /> <br />393-9352 <br /> <br />_.Tax Lot No;; /.5.5 - <br />Sec, / Twnshp. Rge, ~ ~,,¢~' <br /> ~ 9963 ":ill Cr. hd. Aumsvi. lle <br /> <br />Plans by:; <br /> <br />Zone Chg. <br /> <br />Address:: <br /> <br />Address: <br /> <br />Lot No; BIk No;; <br /> <br />Water Supply:: <br /> <br />Sewage sepLi ,: <br />Disposal:: <br /> <br />Area of Bldg; <br /> <br />Heating <br />System;; <br /> <br /> Phone:: Address;; <br />Parl,' Cond Use [ Veriance <br /> <br />ill >: 70 <br /> <br />Sub dy. <br /> <br />Min Req, <br />Setbacks:: <br /> <br />Valuation: <br /> <br />Feas. <br />Study: Permit Fee: <br />NO, <br />Stories;. State Surcharge;; <br />Roof <br />Type; Plans Chk,, Fee:; <br /> <br />Lot Size l ,:~.re Corner? <br /> <br />15. 0 <br /> <br />Septic Permit Fee: <br /> <br />BTU Total Fees;; 15.60 <br /> Rapt,, NO:: [ 3-¢)~ <br /> <br />I agree to build according to the submitted p/aris and specifications, the law¢ of the State of Oregon and the Ordinances of Man'on <br />C°unty'Permitexplresifw°rkn°t~120~.~¢%~, <br />SIGNATURE OF APPLICANT: ~-~ <br />VALIDATIONS:; ~ ~ - <br />ZONIng... SEP N , , <br /> y <br />Date --~/,.,~/-- ~"~ - "' <br /> -/ <br /> REMARKS <br /> <br /> <br />