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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, ORE~ON 97.301 <br /> <br /> PHONE 566-5147 <br />CODE-A-PHONE 4::30 P.M ' 8::00 A.M <br /> <br />SIGNATURE OF APPLICANT <br /> <br /> DATE <br /> <br /> BATE: 06/03/87 TIME: 3:32:49p <br />OWNER <br /> CONTINENTAL TELEF~IONE <br />S~TUS ADDRESS <br /> <br /> 215 WE;ST FOREST <br />DETROIT OR 97342 <br /> <br />TAX LOT <br /> <br />CONTRACT CITY UGB <br /> <br />MAILING ADDRESS PUBLIC WORKS AND UTILITIES 8UILDI~)wlsloN <br /> <br />CATEGORY <br /> C <br /> <br />OCCUPANT LOAD <br /> <br />NO OF BEOgOOMS <br /> <br /> PHONE: <br /> <br />LOT BLOCK SECTION TOWNSHIR <br /> <br /> 1 <br />W~DTH DEPTH AREA UNITS <br /> <br /> SITE NUMBER: 1461 <br /> VALUATION.- $15,000.00 <br /> <br />10 5E 105 <br /> IRREG LOT CORNER <br /> N N <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO+ DALKE <br />KEN DALKE <br />P.O. BOX 5051 <br />SALEM, OREGON 97304 <br />PHONE: 585-7408 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVI EN <br />FLEET SURCHARGE -ZONE 7 <br />STATE SURCHARGE <br /> <br />PAYEE: KEN DALKE <br />RECEIVED BY: CL <br /> <br />* THIS IS NOT A PEB4IT. <br /> <br /> 9002510 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PRE'VIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $110.50 <br /> $71-83 <br /> $8,96 <br /> $4.42 <br /> <br /> $195.71 <br /> $0.00 <br /> $195.71 <br /> <br /> $0.00 <br /> <br /> INVOICE NO: 3012 <br /> TYPE: IN CHECK ~: 0 <br /> <br />THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br /> <br />FOLLOWING I~ST BE COMPLETED. <br />ALL .EC SS z m , TIo. H,s <br /> <br />SEPTIC: BY <br />Z~ING: BY BATE <br /> <br />R~RKS: RE-~F <br />HEIST; TOTAL <br /> <br />1T-IS THE, RE~PQN~I'BILTTY OF THE APPLICANT TO ASSURE THAT <br /> <br /> CITY' JURISDICTION: BY ........ DATE ......... <br /> <br /> SETBAcKs~ FR- ' L~ .... ~ .... RR-____ SP-____ <br /> <br />0 STORIES; ] pLANNING ACTION: <br /> <br />OFFICE COPY <br /> <br /> <br />