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Appl. Revd:: weds <br />By ___,,,E,~ <br />Date:: 12/21/77 <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 />Rj-I. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 - 588-5148 <br /> <br />Permit No /? '~/- -~'~ ~'~]~ (.) <br /> <br /> ' <br /> <br />Type of Permit:; __ r~.I ~e~.l-~ m~l~il e home <br /> <br />Address:: <br /> <br />Owner:; <br /> <br />Phone; 364-.5948 ....... Address: <br /> <br />Tax Lot No:: <br /> <br />5341 ~fi~_ta.a ~' ' Xd, S,,lcm <br /> <br />Bldr,, & No,: 1.1.344 <br /> <br />Plans by: <br />Map Page ~E Z~,ne <br />&X2- FU <br />Use of gldg ;: <br /> <br />Zone Chg <br /> <br />Phone: <br /> <br />Phone;; <br /> Cond, Use <br /> <br />Lot No::, , <br /> <br />BIk No;; <br /> <br />__ Address:: <br /> <br />Address: <br /> <br />Sub dy. Lot Size Corner? <br /> <br />Water Supply; <br /> <br />Sewage <br />Disposal:: <br /> <br />Area of Bldg; <br /> <br />Basement;: <br /> <br />Heating <br />System;; __ <br /> <br />BTU:: <br /> <br /> Valuation;; <br /> <br />Study:: exist: no Permit Fee;; 1,5.00 <br />.o,, Z' ¢&¢ <br />Stories::, ' State Surcharge:: <br /> <br />Type:: <br /> <br />Septic Permit Fee:: <br /> <br />Total Fees:: <br /> <br />Rcpt. NO:; / ~0 / <br /> <br />I agree to build according to the submi'tted/p~/and specificatio~,,~'l~ of the State of Or~on and the Ordinances of Maribn <br />VALIDATIONS:; <br /> <br />ZONIN~i,~ , SEPTIC TANK <br /> <br />R.EJVIAR KS <br /> <br /> PLANS <br /> <br />~,~.~ <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 588-5036 <br />Other permits required by this dept:: Plumbing L~ Electrical ~ <br /> <br /> <br />