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AppI, Rev~!: WedL~esday ,, <br />By, SR <br /> <br />Oate: 2/16/77 <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 />R.H. WlTRROW, BLDG. ADMINISTRATOR <br />588-5147 -- 588-5148 <br /> <br /> addition to a mobile home <br />Type ot Permit. Tax Lot No <br /> <br />Address:; ?01S Old Lumsville ~Jwy. $~', Sec lS <br /> ........ Twnshp, __ <br /> <br /> Dennis Folsom 362-2319 same as a~ove <br />Owner: Phone:: Address;; ............. <br /> <br />8 2W <br />Rge, <br /> <br />Bldr. & No: ................................... Phone:: .............. Address: <br /> <br />Plans by:; Phone: <br />..... ~'6"~;~82.5 ........ ~.z'%"~ J <br /> j Zone Chg Fart Cond, Use <br /> <br /> / <br />Use of 81dg, <br /> addition O office fo~ personal use <br /> & a Deoro~z~ <br /> <br />Lot No; .BIk,, No Sub dy,, <br /> well <br /> <br />Water Supply;; <br /> <br />Sewage hxisting Feas,, <br /> · ._, Study <br />Disposal;: ~¢~.~_ 74N-~2238 (1200 gal. )'-' <br /> <br />Area of Bldg; <br /> <br /> Roof plywood <br />Basement:: Type:: <br />Heating <br />Systerm <br /> <br />Address:; <br /> Fire Zone Occupancy <br /> <br />Type .of Co~-t <br /> Reor <br /> <br />Valuation; <br /> <br />Permit Fee;; <br /> <br />State Surcharge;; <br /> <br />Plans Chk Fee:: <br /> <br />Lot Size 4.84 aCr~orner7 <br /> 4$000 <br /> <br />27.00 <br /> <br />.81 <br /> <br />Septic Permit Fee: <br /> <br />BTU:: Total Fees:: 27.81 <br /> <br />.......................................... /'? // .... <br /> <br />Cour~ Permit expJ~es J'f work not~cC wlthln 120 da~. // 7- // <br /> <br />ZONING SEPTIC TANK PLANS . . h/ <br /> ................. 4J <br /> <br /> REMARKS <br /> <br />PLEASE NOTE:; Driveway and sidewalk inspections are required by Public Works: 588.5036 <br />Other permits required by this dept: Plumbing [] Electrical ~ <br /> <br /> <br />