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MARION COUNTY <br />.~...~ ~(~ _ '[Tf DEPT. OF BUILDING INSPECTION' <br /> <br /> Appl. Revd: ,'Jon~s;y' Downtown Senator Building <br /> 220 High St., N,E, 2nd Floor Permk No. ~ ~ '~ ~ <br /> Salem, Oregon 97301 ~ <br /> By ,~' ~c R.H. WITHROW, BLDG· ADMINISTRATOR By: __ <br /> <br />Type of Permit; <br />Address:.( Rto <br /> <br />Sylvester Pavlicek <br /> <br /> Kilroy's Mobile <br />Bldr,&No_; 4907 <br /> <br />Mobile ~iome ~placement & Electrical Connection <br /> , __Tax Lot NO: <br /> Gox 215-AE)- Aurora 20822 Olmstead Rd. NE <br /> Sec. 28 Twnshp, 4S Rge. 1W <br /> <br /> Phone',-678-5709 Address: ~ same s~s above <br /> Sales <br /> Phone:~ Address; Sg~OR ~. ¢ ~ <br /> <br /> Salem, OR 97303 <br />Plans by; Phone; Address: <br /> <br />U~e of Bldg.: Min Req. Front Sides~d.e.s ( I( <br /> residence _ 2 bedroom SeTbacks', ~.~,~ ~ <br /> <br />Lot No: BIk. No; Sub dy. Lot Size 2 '1/2 acre~ <br /> <br />Water Supply: well Valuation: __~ <br />Sewage ezisting septic Feas. ~.00 <br />Disposal'. Study; Permit Fee; <br /> <br /> No. 2.00 <br />Area of Bldg; 28 ~ ~ Stories: State Surcharge: ,,, <br /> <br /> Roof <br />Basement; Type: Plans Chk. Fee: <br />Heating <br />System; Septic Permit Fee: <br /> <br />BTU: Total Fees; 52°00 <br /> Rcpt. No; ? <br /> <br />I agree to build according to the submitted plans and specification% the laws of the State of Oregon and the Ordinances of Marion <br />County. Permit explre~ if work ¢qt cor~men~ed/~vithln l'20 ~ays. ~ ~ ~ <br /> <br />VALIDATIONS: ~ ~'~/~/ ~ <br /> By=, 8~,~ ..... <br /> REMARKS <br /> <br />1,OOO g~. septic tank. 175 ft. drainfield. ;k~bile home being replaced was~i~taced <br />be fete per'mit was required (1971). <br /> <br />PLEASE NOTE: Driveway and sidewalk inspections are required by Public Works: <br /> Other permits required by this dept; Plumbing [] Electrlcal <br /> <br /> <br />