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AppL Reed,; <br /> <br /> Dot~e <br /> <br />O_~ta,'_ 6/3/85 <br /> <br />MARION COUNTY <br />DEPT. OF BUILDING INSPECTION <br /> Senator Building <br /> 220 High St., N.E. 2nd Floor <br /> Salem. Oregon 97301 <br /> <br /> SaS-S147 -- 588-5148 <br /> <br />Type of Permit: .... <br /> 20357 ~ighway 99F- Aur~a <br />Aridress: · , ~. <br /> A. L. Kokel & Liru/a ~ ~a~_ <br />o~e~: ....... p~; 981 3053 <br /> <br />~ldr. & No.: p =~va[e.. .. P~ .. Phone:. <br /> <br />Permit No.: g5~a~ <br /> ~leg. #z2~7 <br /> <br />By: ... p~ <br /> <br /> 5:00 P.M ....................... CODE-A-Phone ...................... 6:00 A.M. <br /> ...... Date: ~-18-85 <br />~obile ho~e replacement & sep~i~ au~hor~.~tion notice -~o f~eld ~nspo requ~u~ed <br /> Tax Lot No.; ...... <br /> S,¢.: ~Twnshp.: .Z//~ ~Rge.: ~ <br /> <br />Address: ... <br /> <br /> Address: <br />Plans by: Phone:. . .. ,.... ..... <br /> <br />Comer?- <br /> <br />Lot No.: -. : ..BIK. No.: . Rub. dy/ <br />Ar~a of BI,g. 2nd l~a.se- Total <br />Main Fir.: ~. Fir.: ment: Are~; 1~58 Valuation- .. <br /> Bldg. Permit 35.00 <br />ROOf Type; Tru~Sfick' Height: .. Fee: (+ 5%} ~.75 <br />Heat~g Wo~ Water 20.00 <br />System: Sto~: Supply: ~ El~t. F~: .............. <br />Septic Tank New <br />Site EvaL; ~ _ instal.: . M~h. Fee; <br />Exist. <br />System: .Gals.: _ , Plumb. Fee: <br /> State 2.20 <br />VALIDATIONS: ~X ~/~ Sur~harge:J4%) .... <br /> <br />Oate~ ~~~ Date:.,, <br /> <br />Oa~e:_ · ~./ ~ ~ o Date: <br /> <br />I agree tO build accord/,~g to tile submitted place and specifications, the law.~ of the <br />State of Oee~;o, and the Ordinances of Mellon County. PERMIT EXPIRES IF WOflK <br />NO T COMMENCED WI THIN 180 DA ¥S. I ful~her expressly wail'ant that I eom~Jy with <br />the provl$iods o! ORS ?Ot. O05 to 701.125 becaoae.- <br /> <br />The work will be performed <br />by a registered bullda~ <br />Other (l~lease specify) <br /> <br />J I affl performing work on a property I own <br /> Or OCcupy <br />J I eft7 s registered builder OR ( the <br />authorized representative of a <br />reglste~ed builder <br /> <br />Plans Chk. Fee: __ . <br />Septic Tank <br />Permit Fee: 10.00, <br /> <br />DEQ Surcharge: , <br /> <br /> 73.95 <br />TOTAL FEE;_ <br /> <br />RECEIPT NO.: ~ , , ... <br />Driveway <br />Permit Fee: . <br />Site Plan <br />Review Fee; .... <br />Public Works <br />Receipt '~o,: <br /> <br /> The old mobile home will be used for ~°rage - all interior will be removed. <br /> <br />/have read th/~ application in it, entiretj/ and~at~ stared information is,rue and correct to the best o,~'~-"m-), lc'now/edge. <br /> <br />SIGNATURE OF APPLICANT: __ . v <br /> PLEASE NOTE: Driveway end sidewalk iespecfion~are required by PUblic WorkS: 58a~036 <br /> Other permits ~e~u~red by this ~tept.: Plumbing E~ Ele~ricel [3 Mechanical ID <br /> <br /> <br />