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Ape4, Re'rd; <br /> <br />By; <br /> <br /> · MARION COUNTY <br /> OEPT. OF BUILDING INSPECTION <br /> · Senator Building # 225 <br /> 220 High St., N.E. 2nd Floor <br /> Salem, Oregon 97301 <br /> R.H. WiTHROW, BLDG. ADMINISTRATOR <br /> 588-5147 - 588-5148 <br />5:00 P.M.. ........... CODE-A-Phone 5B8-$373 ........... 8;00 A.IVI. <br /> <br />Type of Permit: site evaluation <br /> <br />Owner: Thomas B. Hill Jr. <br /> <br />Tax Lot No: <br /> <br />Phone; Address:1375,,~9nt St. NE, Salem <br /> <br />Bldr, & No.:C°ntact - <br /> <br />Plans by: <br /> <br />U~e or <br /> <br /> =o serve po~ble tr~ch <br /> office and facilities <br /> Lot No: __ 81k. No'. <br /> <br /> well <br /> <br /> Sewage proposed septic Site <br /> <br /> gusse% Fetrowph-ona: 3~3.-_9225 Address: ...... <br /> <br /> Phone: Address: <br />ZoneChg, "'~art~ .......... Cond, Use I Variance FireZone [ Occupancy Type o' Con~t, <br /> <br />Sub dy. <br /> <br />Veluation: $ <br />Permit Fee: <br /> <br />Lot Size_,kC- .~c~-~Corner? <br /> <br />Area of Bldg; Stories: , State Surcharge; <br /> Roof <br />Basement; Type: Plans Chk, Fee; <br /> <br />Heating <br />System: Septic Permit Fee: <br /> <br />60.00 <br /> <br />BTU; Toter Fees: __ <br /> Rcpt. No: ,, <br /> <br />VALIDATIONS: ~f _<~._.~_ <br />ZONING _ SEPTIC PLANS <br /> <br />I agree to build ~cord/ng to the submitted plans and spec/f/catMns, the Mw$ of the State of Oregon and the Or/dnancesofMa~/on <br />County, Permit expires if work not commenc~ w/thin 120 days. I furhter expressly warrant that I comply with the prow~/ons of ORS <br />701,~5 to 70L 125 because: <br /> <br />{ ) / am a r~/stered builder or ( ) the authorized representative of a re¢isrer¢ builder <br />( ) The work willbepedormedby~r~isreredbuilder <br />{ ) I am ¢erforming work on ¢ property I own or occupy <br />( ) Other (please ~/fY) <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are req~ir;d by s: <br /> Other permits required by this dept: Plumbing [] Electrical <br /> <br />588-5036 <br /> <br /> <br />