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Zoning Validation ,> :_ ~ ~ , , '~ .. -= ~ ~ , , · <br /> <br /> // , ~ : Salem~ Oregon 97301 / ' _- -' · <br /> , ' /t~ef [ Right <br />Date ...... ..' ¢ . .,,~~n~ss~-SlS7 = " , .q [Siee ~'. SiSe <br /> <br /> Property Owner . Phone:: ",~>>~ .......... <br /> <br />Job Address <br /> <br /> ~L-- '?~o I ?- <br />Subdivision <br /> <br />Mobile Home Park <br /> <br />Section y.l~ Township /~ <br /> <br />Lot Width <br />~ ._[ Lot Depth <br /> <br />Range '~'"'~_~. Zone <br /> '[- Irreg i'~ ~a,..~ <br />Acres '] ~orner <br /> <br />JSite No <br /> <br /> ~p~r~ Tax Lot No. <br /> <br />Cross Street <br /> <br />Fleet S/C Zone <br /> <br />B,ook /g <br /> <br />Total ¢¢- Spaces <br /> <br />Contractor Business Name and NO <br />~_~ rob 7t ~-c.~ <br /> <br />Phone:: - ~;,~dress <br />Phone:: <br /> <br />Type of Permit:: I ~w f~/ Addition ['1 Demo [] Tach <br /> <br /> / /' Alter r~ Relocation LJ Ccc Chg [] Review [] <br /> <br />Height of Building ...... No Stories Sq Ft~6-P/-f}vlai~OOr - ~ ~(~nd Floor:: <br /> <br />Mobile Ho~e Mobile Home ¢ Bedroom8 b6c~ <br />Width ~_~ Length ~ <br /> <br />Use of Buildidg RES L~ <br />n COM ~ <br />Sql Ft Garage:: Other <br /> <br />Occupant Load:: <br /> <br />Water Supply <br /> <br />Proposed Septic Installation <br /> Previous Site Evaluation ¢ <br /> <br />Type of ~y_~!er'n <br />Te_s~. HOleS Ready <br />Will call when holes ready <br /> <br />Existing Septic System <br />Existing Tank Size <br /> <br />Ex~sbn9 Dreinfield Length <br />Type of System <br /> <br />DQ!Q.Tank Ru_?ped <br /> <br />PropoPed Bedrooms <br /> <br />Existing Bedrooms <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPI',: PLUMBING, MECHANICAL~ ELECTRICAL <br />MC 15,6 <br />Rev t2B7 <br /> <br />Valuation <br /> <br />Bldg Fee <br /> <br />Mobile Home Fee <br />Fleet Surcharge <br />Zoning Surcharge <br />State Surcharge <br />Plans Check Fee <br />Sde Evaluation Fee <br />Septic Permit Fee <br />DEQ Surcharge:: <br />Technical Review Fee <br />Reinspection l=ee <br />Investigation Foe <br />City Fee <br /> <br />TOTAL FEE:: <br />RECEIPT NO <br /> <br /> <br />