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MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> <br />Appl_ Reval: ~"cidc~y Downtown ,~enetor IBuildir',g <br /> 220 High St., N.I=. 2nd Floor Permit Ne_ 7 <br /> Salem, Oregon 97301 c- <br /> ~e[~- .- ~ IR.J4. WiTHROW, BLDG. AI:)MINISTRATOR By: ,,'J <br />By: ....... <br /> 588-5147 -- S88~148 <br /> <br />Date; 10-?_~J- 77 Da~: <br /> .... Sec, -~ ,_a T ~shp. __Hge. <br /> <br /> 749-2003 <br />Owner: [.'loyd,.,,~ Burk 'g: Phone,* Address; <br /> <br />$1dr. & No.: Phone: .... Address: <br /> <br />Plans by; Phone: <br /> ~obile <br /> <br />Min Re~. <br /> <br />Lot NO: ....... SIR. NO;__ Subdv. <br /> <br />Water Supply; <br /> <br />~ewage Fees. <br />Disposal: .,, exi~Lfn~ Study: 74-1198 <br /> No,, <br />Area of Sldg: 12 x 65 Stolid: 2 bedrootes <br /> Roof <br />Savant: TY~: <br />Heating <br /> <br />BTU: <br /> <br />Valuation.* <br />Permit Fee:_ <br />State Surcharge: <br />Plans Chk, Fee: <br />Septic Perml~ Fee: <br />Total Fees: <br /> <br />RODt, No: <br /> <br />15.00 <br /> 60 <br /> <br /> 2O <br />1~ _~O <br /> //Ft <br /> <br /> build according to the ~ubmltZed plans and specificat/ofl$, the la~ ~ ~ $~ of O~fl ~ ~ 0~/~ of Mwio/~ <br />~mlt explr~ if ~ ~t m~nc~ wi~ifl 120.~a~, ~ <br /> <br />VALIDATIONS; <br />ZON I FJ~~ _~, SEPTIC TANK <br /> <br />REMARKS <br /> <br />PLANS <br />By; ~r.~~' <br />=..: .......... <br /> <br />_._H(~£1e._ho~e re!,.~[~c,~e for £~rm labor - o=:L,~, permit <br /> <br />h 7o <br /> <br />PLEASE NOTE: Driveway ands'idewelk Inspeatmns' ere required by Public Works: <br /> Other pe~mlta re<lulre¢l by this dept: Plumbing ~'~ Electrical <br /> <br /> <br />