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Zoning ValidlgiOn: , <br />Da~ ~ ..... <br /> <br /> MARION COUNTY BUILDING INSPECTION 220 High Sneer NE <br /> ' Salem, OR 97301 ~ff%,- <br /> 8.~0 ~'11'~ 4:~0 pm l~O~e $$8-~14~ <br /> Code.-A. Phon~ 588-7904 <br /> FA~ 588-~48 <br /> <br />SiTE EVALUATION AND/OR ~ilgl~flC PERMIT APPLICATION <br /> <br />Contractor lnformatiol <br /> <br />' She EvM,ation, first~..I000 Ra). DSP $ ~.~ 20.~ ..... <br />Cons~¢ ~on & ~r P~m{ a <br /> s~aS~,~ ~, ~.. ~ ~k..~ ~,'~' t0.~ .. <br /> S~d ~ m~ fl~n I ~ g~l. <br /> C~pin~ Fill ;~0,~ 10~'~ <br /> Di~sal Trencl~s in $a~lite , ' .......... ..... <br /> Gray Water Wmto ~s~ .Sump <br /> Ilolding Tank ~ 2~.~ 10.~ ..... <br /> Pr¢~we Dis*rlbudoa ~0.~ 10.~ <br /> $aad PiR~ $$5,~ 10.~ <br /> ~epage ]?~0ch 2~*~ 10.~ <br /> '1~1, ~wal~Jng g~$~em 280-~ 10.~ <br /> Plan Revi*w <br /> 6~ gal. DSE 1~1 g~. DSF <br /> (eXC&pt S~D FILERS) <br /> Alteratioa~ 2~,~ 10.~ <br /> Consm~¢fion P~aot Roaowfl ~iel~ Visit) 12~ 10,~ <br />~ns~cdon ~rmit Ro~wal ~o FicM ~ai~) 70.~ 10.~ <br />~st~m Evalu~on Re~ 120.~ 10.~ <br />Au~ori~tfion N~i~ ~ld Vifi0 <br />Annual Eval~ti~ of Aheraafi ~ Syslem ' t20.~ 10,~ <br /> <br />(Ma~k i/Applicable to fids Appllca6oa) <br />( ) T~s~ Iqol~ at* Dug <br />{ ) ~ will call whtm Tast l-[ol~.~ I'~lg <br /> <br />) I am i~rf~xmlng w~-k on a pro.ny I c~n or ~cupy <br />) i ~ a r0g~.qter0d ~Ider <br /> <br />) ~ ~rk will ~ ~ff~m~ by a DEQ ~nsed lm~talI~ <br />) OUter <br />) I agt~ to install ~diag to <br /> <br />Reaidenfial Si~l~,,Faial)y <br />$~valu~.fiontfk~tl0t .......... $ 2(~-~ g20,~ ~ ............. <br />H~ag Tank <br />Rural ~m V~an~ Si~ Evaluafi~ 2~.~ ~0.~ <br /> <br />Red,iix No, <br /> <br />NAME OF APPLICAN'f (plea.~e print): <br />$1C. NA'I'LIRE OFAPPLICANT: DATE: <br /> <br /> <br />