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Appl. Revd: , , )' <br />By: <br /> <br />Date: -" '- ~g <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 />R.~. WITHROW, BLDG. ADMINISTRATOR <br />588-5147 -- 588-5148 <br /> <br />Owner: .,'!'~ru, !]. C.t':i.l'n Phone: <br />Bldr. & NO ' ;; I:'im Phone: <br /> <br /> Mep e <br /> <br />Use of <br /> <br />' '" c~"l 0~.'Add 11553 :h c' <br /> <br />Address: <br /> <br />Lot No; .Elk, No: Sub dy. <br />Water Supply: ~x,e 1 ! <br /> <br />Sewage Feas. <br />Disposal; Jeptic Study: 9-76-7 <br /> <br /> No. <br />Area of Bldg; -I-~:,60 s . :f~'i:Stories: 1 <br /> Roof <br /> <br />Heating <br /> <br />BTU: <br /> <br />Valuation; <br />Permit Fee: * 45.50 <br />State Surcharge: 5 o ~¢2 <br />Plans Chk. Fee: <br />Septic Permit Fee; _37.50 <br />Total Fees: 1SS :¢2 <br /> <br />Lot Size .___[, ~,!;,,.r ,, Corner? ~'to <br />40~ 000.0,'~ <br /> <br /> 0pt. No: <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: 588-E036 <br />Other permits required by this dept: Plumbing [] Electrical [] <br /> <br /> <br />