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Recefved By ~,. Jansen <br /> <br />MARION COUNTY BUILDING INSPECTION city setback ReQuirements;; <br /> <br /> Sen~or Bidg,, No,, 22.5 <br /> sec High St~et NE <br /> Salem= Oregon 97301 <br /> <br />MOBILE HOME [] SEPTIC [] <br /> <br />'20' Roar 5' <br />-- Right <br />5 ' Side;: 5 ' <br /> <br />PERMIT APPLICATION <br /> <br />F~f%~il?t,t_, ~:. ..... 399-5751 1655 25th St. Se. Salem, Ore. 97302 <br />~¢ 's~:' 'j'lY Site No,,;: Cross Street:; <br /> <br /> 930 Lincoln 'Street, Aumsville, Ore. 97325 Property T~ Lot NO:: Fleet S/C Zone:: <br /> 90061-251 <br /> Subdivisio~ Lot:; Block:; <br /> Gildow ~ II ~. 3 ....... <br /> Mobile Home ~rk:: Sp ~:; Tetal ~ Spaces;; <br /> <br /> 25 8 S ...... 2~ RS <br /> Lot Width:: ~t Depth:: Acres;;I Irreg ~t: Corner:: <br /> 87.07 97.65 ....... ] Yes NQ ........ <br /> <br /> ore. Housing and Associat,ed SErvice~ . 585-619:11395 LibD~t¥ St. S.E. Salem, Ore. 91302 <br />IDavid G. Pool L 363-0361 [6493 Doral Drive S.~. Salemr q.~. 97302 <br /> <br />Type of Permit New;; x;;~ Addition [] Demo:: [] Tach,, Use of Building:: RES ~: <br />Const, r~ct'.on Alter;: [] Relocation [] Oc~, Chg:: [] Review;: [] Single Eamily COM [] <br /> <br />Height of Building;: <br /> <br />No. Stories' <br /> 1 <br /> <br />Moblle Home Mobile Home <br />Width;; Length:: <br /> <br />Proposed Septic installation:: <br /> Previous Bite Evaluation ¢/~:: <br /> Type of System;; <br /> Test Holes Ready; <br /> Will call when holes ready:: Proposed Bedrooms:: <br /> <br />Sg,,1008Ft, Mains~FIoor::,¢%. Sq Ft,, 2nd Floor:: <br />Bedrooms:: Occupancy:: <br />3 Sin~l..e Family <br /> <br />Sq, Ft, Garage:: Other <br />320 sq...ft. <br />Occupant Load;: Water Supply:: <br /> City <br />Valuation:: $ 32. 000.00,.. <br /> <br />Existing Septic System:: <br />Existing Tank Size, <br /> <br />Existing Dralnfleld Length' <br />Type of System:: <br />Date Tank Pumped;; Existing Bedrooms:: <br /> <br /> L~) I have read this application in it8 entirety and certify that the stated information Is <br /> true and correct to the best of my knowledge <br /> ) I am performing work on a property I owr, or occupy <br /> ) I am a registered builder OR (t-i~e authorized representative of a registered <br /> builder, <br /> ~'~ The work will be porformed by a regiatered builder, <br /> Other <br /> I agree to build aocordin,~ to the submitted plans and speoifications~ thc. laws of <br /> the state of Oregon an cee of Marion County <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15-6 <br />Rev 12/~7 <br /> <br /> Bldg,, Fee;: <br /> <br /> Mobile Home Fee <br /> Fleet Surcharge:: <br /> <br />City Z~3f~i~9/Surcharge:: <br /> State Surcharge: <br /> Plans Check Fee:: <br /> Site Evaluation Fee:: <br /> Septic Permit Fee:: <br /> DEQ Surcharge: <br /> Technical Review Fee;; <br /> Re~napection Fee;; <br /> ]nvestigation Fee;; <br /> City Fee:: <br /> TOTAL FEE:; <br /> RECEIPT NO,;: <br /> <br />$_ 206.50 <br /> <br />3.84 <br /> <br />..... <br /> <br />,,, <br /> <br />134.23 <br /> <br />See Above <br /> <br /> 365.23 <br /> <br /> <br />