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MARION COUNTY <br />,. DEPT. OF BUILDING INSPECTION <br />App[, Revd'.~ q~tZ~=c[y~ Downtown Senator Building <br /> 220 High St,,, N,,E. 2nd Floor Permit No _ , <br /> Salem, Oregon 97301 ,_~- ~. <br />By:: '~, .ps R.~I. WITHROW, BLDG. ADMINISTRATOR By; <br /> 588-5147 -- 588-5148 <br /> <br /> moblle home <br /> Typeof Permit. ~t~t~ ~n~"~ ~m~w C~n~& &'~+~e~ Tax Lot NO:: <br />Address [~76 ~. Aumsvil[c ~e ¢,o.~. <br /> Sec. Rge, <br /> ~Joyce <br />Owner:: , .. ,,.,=][- ~ Phone: Address: <br /> <br /> ~el Saw,er 623-5861 17415 3ro~ Rd. D~lla~; 97338 <br />Bldr & No: Phone: Address: <br /> <br />Plans by:; Phone:: Address: <br /> <br />_,~1'es.Setbacks <br />Lot No:; BII<, No Sub dy,, West Staytozz Lot Size <br /> <br />Water Supply:: C~ty Valuation;; <br />Sewage Peas,, <br />Disposal:; septic Study;; existing Permit Fee: 15.00 <br /> <br /> 10 x 50 NO. <br />Area of Bldg; Stories: State Surcharge: .60 <br /> Roof <br />Basement Type:: Plans Chi<. Fee: <br />Heating <br />System;: __,~o]~.,.], Septic Permit Fee; <br /> <br />BTU Total Fees;; _ 15.60 <br /> No:: <br /> <br />I agree to build according to the submi'tted <br />County, Permit expires i'f work not commenc, <br />SIGNATURE OF APPLICANT,~'~ <br />VALID ~A~, ~ [ <br /> <br />spec/f/cations, the laws of the State of OreEon and the Ordinances of Marion <br /> <br /> PLANS-- <br /> <br /> REMARKS <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 58S-5036 <br />Other permits required by this dept;; Plumbing ~ Electbcal [] - ~*- <br /> <br /> <br />