Laserfiche WebLink
~Received'~y~ <br />zCotnYing Validation_ ~ <br /> <br />MARION COUNTY B U I L DI NJ;]i:~N,.~P E~T,[O N~ /~ City_~ Setback,,__Requirements::[__ <br /> <br /> 220 High $tre~ / ~ <br /> Salem, Oregon g73~ ~ ' <br /> <br />Property Owner' / ~ I / / Phone Mai~ <br /> <br />Job Address Site No, Cross <br /> <br /> ' Property T~ Lot No:: Fleet <br />Subdivisio~ Lot::~ <br /> <br />Lot Width <br /> <br /> Range <br />Lot Depth Acres <br /> <br />Zone~_~.~ Map <br />grog Lot Corner:: <br /> <br />Phone 1 Address; <br />Ph,on¢; ~ddress:; <br /> <br />Contractor Business Name/~ <br /> <br />Type of Permit <br /> <br />Alter:: <br /> <br />Addition [] <br /> <br />Oemo:: [] Tach <br />Ccc Chg [] Review <br /> <br /> f~ Relocation:: [] [] <br />Height of Building Sq Ft Garage Other <br /> Occupant Load <br /> <br />NO, Stories:: Sq Ft Main Floor Sq Ft 2nd Floor <br />Mobile Home 4 # Bedrooms Occupancy;: <br />· e.gth 70-/ ,. i <br /> <br />Mobile Home <br /> <br />COM L~ <br /> <br />V~luation <br /> <br />Proposed Septic Installation:; <br />Previous Site Ewluation ¢ <br /> Type of System:: <br /> <br />Test Holes Ready:: <br />Will call when holes ready <br /> <br />Proposed Bedrooms <br /> <br />Existing Septic System <br /> Tank Size <br /> <br /> Date Tank ~urrlp?d~ ........... <br /> <br />( I~ I have re~d this application in its entirety and certify that the stated information is <br /> <br />OTHER PERMITS REQUIRED BY THIS DEPT,: PLUMBING, MECHANICAL~ ELECTRICAL <br /> <br />Mobile Home Fee:: ........ <br /> <br />Zoning Surcharge <br />State Surcharge I~ <br />P~ens Check Fee ~, ::~,;Z_)_ <br />Site Evaluation Fee' <br />Septic Permit Fee <br />DEQ Surcharge:: <br />Technical Review Fee <br />Reinspection Fee <br /> <br />Investigation Fee <br /> .5 ,oo <br />City Fee:: <br /> <br /> <br />