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Appl, Revd- <br /> <br />Da,e: MAY 7~ ~79 <br /> <br /> MARION COUNTY <br /> DEPT. OF BUILDING INSPECTION <br /> Senator Bui~dlng # 225 <br /> 220 High St, N.E, 2nd Floor <br /> ~alem, Oregon 97301 <br />R.H.'WITHROW, BLDG. ADMINISTRATOR <br />588-5147 -- 888-514S <br /> <br />Type el" Permit: P~FT~CEIVJ~[~J[' OF S~TI(~ TANK ,~D D~INFi~ Tax Lot NO: <br /> <br />Owner: ~, ~N$O~ Phon u.o ~ ~dre**: BOX Z6~ AU~O~ <br /> <br />81dr. & No * J0~ ~iTE INSTALLE~hon=; .... A~dress: ...... <br /> <br />Rge. <br /> <br />Pians by: Phone: Address: <br /> <br />Use of 8tdg, <br /> No Bdrm~ M~n ~ FroRt ~ ~ldes ~ Rear <br /> <br />Lot No: --Elk NO, <br /> <br />Sub dy, Lot Size 1 ~-. Corner?. <br /> <br />Watar Supply: ~T~LT .......... Valuation; .~ <br />Sewage SRe <br />Disposal: SEPTI~ Evah ~___ Permit Fee: <br /> No. <br />Area of Bldg. ~ Storles; State Surcharge: <br /> Roof <br />Basement: Type: Plans Chk. Fee: <br />Heating <br />System, Septic Permit Fee: . . <br /> <br />BTU: ........ Total Fees: <br />......... <br /> <br />SIGNATURE OF APPLICA~' ~~'~"~ ~ <br /> <br />PLANS <br /> <br />It ~,~ an old me~al ta~ an~ has app~ line of 50 <br /> <br /> ........, ,, <br /> PLEASE NOTE- Drivewa~ a~ sidewalk i~cfions am r~uired by Publlc Work~ <br /> $~8-5036 <br /> Other permits r~uir~ by this clapt: Plumbing ~ Electrical <br /> <br /> <br />