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City ! <br />Zoning Validation: <br /> <br />D~te <br /> <br /> BUILDING [] <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ~enator Bldg. NO, 22g <br /> 220 High Street NE <br /> Salem~ Oregon 97301 <br /> <br /> Phone S88-5147 <br /> Code-A-Phone 4:30 RM. - 8:00 A,M. <br /> <br /> MOBILE HOME [] SEPTIC [] <br /> <br />  Setback Requirements: <br /> <br /> t; Roar: <br /> <br /> R ght <br /> Side: Side; <br /> <br />PERMIT APPLICATION <br /> <br />Owner: Mailing Address: <br /> <br />Idress: Site No,: Cross Street: <br /> ~ Property Tax L No.: Fleet S/C Zone: <br /> <br />Subdivision: <br /> <br />Block: <br /> <br />Mobile Home Park: Sp, #: Total # Spaces: <br /> <br />Irreg, Lot; Corner: <br /> <br />Contractor Business Name and No,; <br />Architect/Engineer; <br /> <br />Phone; <br /> <br />Phone; <br /> <br />Address: <br /> <br />Address: <br /> <br /> ~pe of Permit; New: [] Addition: [~ Demo; [] Tach. Use of Building: <br /> Alter; [- melocation: [] Ccc. Chg.: [~ Review: [] <br /> <br /> Existing Tank Size: ¢ ~ ~ ~ <br /> <br /> Date Tank Pumped ~ <br /> <br /> I have read this applicaSo~~ <br /> tr~e and correct to the best of my know <br /> <br /> ~ am a registered builder OR ( ) the authorized representative of <br /> builder. <br /> <br /> Other ee: <br /> <br /> TOTAL FEE: <br />OTHER PERMITS REQUIRED BY THIS DI=PT-: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 RECEIPT NO,; <br /> <br />COM D <br /> <br />Other: <br /> <br />Water Supply: <br /> <br /> <br />