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Zoni% Validation: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> Senator Elleg, No. 22S <br /> 220 High Street NE <br /> Salem, Oregon 97301 <br /> <br /> Phone 5aa-$147 <br /> <br /> BUILDING [] MOBILE HOME <br />PropertyOwneri- ..~,. ~', .,t~-~~'~'~hoee:,~ <br /> <br />Subdivision- / <br /> <br />MObile Home Park: <br /> <br />SEPTIC ~/PERMIT APPLICATION <br /> <br />' Mailing Address; <br /> <br />P~io~edy Tax Lot No.: <br />Lot: ~. <br />Sp, #: <br /> <br /> ross 'Street: <br /> Fleet S/C Zo~ <br />.... Block: j%~.~._ <br /> Total # Spaces; <br /> <br />Archit@cl/Engineer: <br /> <br />Phone: <br /> <br />Phone; <br /> <br />............. "Address;Address: <br /> <br />f Permit: New: [~ Addition: ~ Demo: [] Tach. <br /> <br />Use of Buildia§; RES ~ <br /> <br />Alter: [Z:J ReJoc~,tiom O Gcc. Chg.: ~' Review; [] <br /> <br />Height of Building: NO, Stories: <br /> <br />Sq, Ft, Main Floor: Sq. F~, 2nd Floor: <br /> <br />Mobile Home # Bedrooms: Occupancy: <br />VCdth: ~ <br /> <br />Proposed Septic tnstallat~On: <br /> Previous Site EveJuati0n //; <br /> Typo of System: <br /> Test Holes Ready; <br /> Will call when holes ready: __,,Proposed Bedrooms: <br />Exisdr'~ Septic System: -- . r-~'~ ~ <br /> Existing Tank Size'. Q~: ~',~ <br /> <br /> T~pe o~ System: .?% ~., ,& F{,_~ ~.¢-.-¢h%--;T~-% .................. <br /> Date Tank Pumped: I[~jl~ ~ I ~xisdn0 eedrooms: I <br /> <br />Sq. Ft, Garage: Other: <br /> <br />COM <br /> <br />Occupant Load: <br /> <br />Bldg. Fee: <br /> <br />Zoning Surcharge: <br /> <br />Septic Permit Fee'. <br /> <br />City Fee: <br /> <br />RECEIPT NO,; <br /> <br /> <br />