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o ' g a[dat'on;._.~-~-. <br /> <br />Job Address: <br /> <br />Mobile Home Park; <br /> <br /> MARION COUNTY BUILI~,j~ INS. EECTION rcity Setback Requirements: <br /> Sen~or Bldg.N~ /~ ~. ~ ~N ~/~' ~,, ~ ,' ~ ~ -- / <br /> <br /> Salem, Orego~7~l 1~;~ , ~ ] / .... <br /> <br /> BUILDING ~MODILE HOME ~ SE~"~.0~MIT~PPLICATION <br /> <br /> site No,;'"'-- Cross StreW: / .................. <br />~Z~/ ~ ~S ~7/* Property Tax Lot NO.: Fleet ,/0 Zone: <br /> <br /> / <br /> <br />Section: <br /> <br />Lot Width: <br /> <br />Township; <br /> <br />Lot Depth; <br /> <br />Zone; <br /> <br />Irreg. Lot: <br /> <br />Map; <br /> <br />c°r O <br /> <br />iContr~ctor BUSJ~.SS Name and No,~ <br /> <br /> Archite~/J~ngineer: ~ __ <br /> _ <br /> <br />Addition: [] Demo: [] Tach. Usa of Building: <br />Relocation: EJ gcc. Chg.: [] Review: [] ~. <br /> Sq. Ft. 2nd Floor'. Sq. Ft, Garage; <br /> <br /> Occupancy: Occupant Load; <br /> <br />Height of Building; ] No, Stories: <br />/¢'/ [ / <br />Mobile Home ..... Mobile Rome <br />Width: Length; <br /> <br />Proposed Septic Installation: <br /> Previou~ Site Evaluation #: <br /> Type of ,S.¥etam; <br /> <br />Test Holes Ready: <br />Will call whe~ holes ready: Proposed Bedrooms: <br />Existing Septic System: <br />Existin9 Ta~ Size; <br />__ _~_x.!~!!_n_g. Orainfield Length; <br />Type of System: <br />Date Tank Pumped: Existing Bedrooms: <br /> <br />builder. <br />The work will be pedormed by a registered ,~lder. <br />Other ........ / I <br />I agree 1o build according to the stlbmitted/flac/s and specifications, 1he laws <br /> <br />OTHER PERMITS REQUIRED BY THiS DEPT.: PLUMBING, MECHANICAL, ELECTRICAL <br />MC 15.6 <br />Rev, 12/87 <br /> <br /> Valuation; <br /> <br /> Bldg. Fee: <br /> Mobile Home Fee: <br /> Fleet Surcharge: <br /> Zoning Surcharge: <br /> State Surcharge: <br /> Plans Check Fee: <br /> Site Evaluation Fee; <br /> Septic Permit Fee; <br />t DEQ Surcharge: <br /> Technical Review Fee: <br />'~ Reinspection Fee: <br /> Investigation Fee: <br /> City Fe~; <br /> TOTAL FEE: <br /> RECEIPT NO,; <br /> <br /> RES <br /> <br /> COM [] <br /> <br />.Supply: <br /> <br /> <br />