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Received By:; ~'~- <br /> <br />Zoning Vslidation <br /> <br />BUILDING [] <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> ~' Senator Bldg. No, 225 <br /> 220 High Street NE <br /> Salem~ Oregon 97301 <br /> <br /> Phone 588-5147 <br /> Code-A-Phone 4:3S A,M. - 8:00 A.M. <br /> <br /> MOBILE HOME [] SEPTIC [] <br /> <br /> 'C~y Se~tbaok Requiremeet$ <br /> <br /> Left ~- I Right <br />PERMIT APPLICATION <br /> <br />Property Owner <br /> <br />Job Address <br /> <br />Subdivision <br /> <br /> Mobile Home Park ~ <br /> <br />Section J i Township ~1 Range <br />"(~t ' th: .~ Lot Depth ,/ Acre~ <br /> <br />Site No, <br /> <br />Property Tax Lot No <br /> <br />Lot <br /> <br /> Sp ~' <br /> <br />Zone/¢¢~,~ Map'"' <br /> <br />Fleet S/C Zone <br /> <br />Block <br /> <br />tractor Business Name and No J <br /> <br />Phone <br /> <br />New .~ Addition:: ~ Demo [] TaCh <br />Alter:: [] Relocation [] Ccc,, Chg, [] Review [] <br /> <br />Height of Building:: m NO Stories:: <br /> /0 <br />Mobile Home Mobile Home <br />Width ~. (.~ / ~. t, Length:: ~ ~ <br /> <br />Sq, Ft, Main Floor <br /> <br />Sq Ft 2nd Floor <br /> <br />Occupancy:: <br /> <br />Use of Building:: I RES <br /> <br />Sq Ft Garege <br />Occupant Load:: Water Supply <br /> <br />Proposed Septic Installation <br /> Previous Site Evaluation # <br /> Type of System:: <br /> <br />Test Holes Read~:: <br />Will call when holes ready Proposed Bedrooms:; <br />Existing Septic System <br />Existing,,,,T, ank Size <br />Existing Drain_field Length <br />Type of System <br /> <br />_~ats Tank Pumped:: Existing Bedrooms;: <br /> <br /> ) The work will be performed by a registered buiide~ <br /> <br /> the ~tate of Oregon and the ordinances of Marion County <br /> <br />Valuation:: $ <br />Bldg Fee $ -/'/~" <br /> <br />Mobile Home Fee <br />Fleet Surchsrge ~ '~'-~ <br />Zoning Surcharge <br /> <br />State Surcharge:: <br />Plans Check Fee:: / ~' ~) <br />Site Evaluation Fee <br /> <br />Septic Permit Fee:: <br /> <br />DES Surcharge <br /> <br />Technical Review Fee <br /> <br />Reinspection <br /> <br />Investigation Fee <br />City Fee:: ~---~.~- <br /> <br />RBOE,PT .0 <br /> <br /> <br />