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City " " ~ <br />Zoning Validation ~__,~, <br /> <br /> MAR~ON COUNTY BUIL,~-NG~N,~IE~T.,IOI~I i=~[~i~y:=Setb~ck <br /> <br /> Phone 588-5147 L bide ,~ <br /> <br />BUILDING ~ MOBILE HOME ~ SEPTI~ ~, ~ERMI~P~ICAT ON <br /> <br />Job Address <br /> <br />Subdivision <br /> <br />Property Tax Lot No:: <br /> <br />Cr~-ss Street <br /> <br />Fleet SIC Zone:: <br /> <br />Block <br /> <br />Mobile Home Park Sp #:; Total # Spaces <br /> <br />Section t Township:: <br />Lot Width Lot Depth <br /> <br />Range <br /> <br />ACreS <br /> <br />Irreg ~.¢ Come ;: <br /> <br />r Cor~tCactor Business Name and No <br /> /- X/z. J',, ,'/,, ,-' <br /> <br />Phonej,/.3/~.7¢ ~, Address:: <br /> //~ddress~, <br /> <br />"~pe of P rmit I New ~/' Addition [~ Demo <br />· ~O,t,t~z~l Alter I-~ Relocation [] Ccc Chg:: [] Review [] <br /> <br />Height of Building <br /> /5// <br /> <br />No Stories:: <br /> / <br /> <br />Sq Ft, Main Floor:: <br /> <br />Use of Building <br />Sq Ft Garage <br /> <br /> Sq Ft,, 2nd Floor <br /> <br />Mobile Home Mobile Hame # Beclr~gams:: Occupancy Occupant Load <br />Width Length <br /> <br />Proposed Septic Installation <br />Previous Site Evaluation # <br /> <br />Type of System <br /> <br />Test Holes Ready <br />Will call when holes ready Proposed Bedrooms <br /> <br /> Existing Septic System <br /> Existing Tank Size:; <br /> Existing_ Drainfield Length <br /> Type of ~ystem <br /> Date Tank Pumped:: Existing 'Bedrooms <br /> <br />t ~i have read th~$ appllcahon in its entirety and certify that the stated information is <br /> <br />(~-'~ i ~'~ a registered builder OR ( ) the authorized representabve of a registered <br /> builder <br />( ) The work will be performed by a regisfered bu~der <br />I ) ~r <br /> <br /> [he state of Oregon and the ord rf¢os of rion Cou y <br /> <br />OTHER PERMITS REQUIRED ~ THIS DEPT.: PLUMBING~ MECHANICAL, ELECTRICAL <br />MC 15-6 <br /> <br /> Valuation <br /> <br />Bldg Fee <br /> <br />Mobile Home Fee <br />Fleet Sumharge:: <br />Zoning Surcharge <br />State Surcharge:: <br />Plans Check Fee <br />Site Evaluabon Fee <br />Septic Permit Fee <br />DEQ Surcharge <br />Technical Review Fee <br />Reinspectian Fee <br />Investigation Fee <br />City Fee <br /> <br />TOTAL FEE <br />RECEIPT NO <br /> <br /> RES <br /> <br /> eOM [] <br /> <br />Other <br /> <br /> <br />