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Thl~'sday <br />A~L Revd; <br /> <br /> Li~da and dc~te <br />By: ~ ~ <br /> <br />Date: 1-~7-80 <br /> <br /> MAI'lION GOUN I Y <br /> DEPT. 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 58S-5373 ........... 8:00 A.M <br /> <br />Permit No, ~;~ --/~,, ,, .,~ <br />By: .~ <br /> <br />Type of Permit; StOyI_~qe sh~.d / hobble shop / GaraGe <br /> 9948 Stayton Rd S,E, A~msville 97325 <br />Address: ,, <br /> <br />Owner; Nell Dick~an <br /> <br /> call co llect <br />Phone: 7~9-5468 <br /> <br />,tax Lot No; <br /> <br />Address: <br /> <br />Bldr,, & No.:_ Phone: Address: I <br /> <br />Plans by: Phone: Address: <br /> <br />Ma~p Pa~ge Zone Zone Chg,, Pa?t, Cond, Use <br /> EFU <br /> <br />Lot No: Blk, No:, <br /> <br /> well <br />Water Supplv: <br />Sewage septic tenk <br />Disposal; .. <br /> <br /> 20X30 <br />Area of Bids: <br /> <br />Heating <br /> <br />BTU: <br /> <br />Sub dy, <br /> <br />Site <br />Evah <br />No, <br />Stories; <br /> <br />Roof <br />Type; ~.f,:~-at trt~$s . <br /> <br />Min Req. Front I Sides I Rear <br />SetbackS~ ~ ~ ~ <br /> <br /> no <br />Lot Size 16,37 . Corner? <br /> <br /> 4,&00.00 <br /> <br />Valuation; <br /> <br /> 32,00 <br />Permit Fee; <br /> <br /> 1,28 <br />State Surcharge: <br /> <br /> 8,00 <br />Plans Chk. Fee; <br /> <br />Septic Permit Fee: <br />Total Fees; 41,28 <br /> <br />VALIDATIONS: <br />ZONt~ ~;~ SEPTIC TANK P LA N.~.¢~/~¢~2~.~ <br /> <br />I agree to build accord/~ to the submitted pMns and spa/f/cations, the laws of the State of Or.on and the Oridnances of Marion <br />County, Permit expires iF work not commenc~ within ~20 days. / fcrhter expr~s/y warraot that /comply with the provisions of ORS <br />701,005 fo 70I, 12~ because <br />( ) I~mar~ister¢builderor( ) theauthorizedrepresentativeofar~isteredbuilder <br /> <br />Thework willbeperformedbyare,21steredbuifder <br /> I am performing work on a property I own or occupy <br />( ) Other (please sp~ify) <br /> <br />REMARKS:: No commercial u.~e of this bldq <br />....... allo J . <br /> <br />I have read this application in /Its entirety and certify that the stated information is true and correct to the best of my knowledge <br /> <br />PLEASe: NOTE: Driveway and sidewalk inspections are required by Public Works: <br /> <br /> Other permits required by this dept: Plumbing [] Electrical <br /> <br />.1 <br /> <br /> <br />