Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM. OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 PM - 8;00 A,M, <br /> <br />Other. <br /> <br />I have read and agree to the terms stated on the reverse side of <br /> <br />SIGNATURE Of APPLICANT <br /> DATE <br /> <br />OWNER <br /> :~03AN3 &L.N, <br />S~1 US ADDRESS <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />8792 HOLMOU I .%-~ RD <br /> <br />CONTRACT CITY <br /> <br />LOT <br /> <br />BLOCK SECTION TOWNSHIP <br /> <br />SITE NUMSER: <br /> V4LATiQN <br />RANGE <br /> <br />ZONE <br /> <br />CORNER <br /> <br />CATEGORY <br /> <br />MAP <br /> <br /> 51 <br /> <br />TvpE: ELECTR]:CAL <br /> <br /> I~EP. MZT OR ,~Pg>LZC;6,TIO~,~ NO: 2133 <br /> <br />34604 SU ERV~SING ELECTRZCZAN/NU"qSER <br /> [~lN,.s_r~ ,/,~ ,,,.d- L/1 ,,69 <br /> <br /> t TEM <br />SEW ,CHANC?ff CNt v-EXISTING RESiDEnCE <br />.C;'~.~' 5URCHARGF -ZONE 3 <br />¢'[_~C~RIC::~L STATE SURCHARGB <br /> <br />TOTAL ASSESSED FEES <br />~/IOUS RmnmT~ <br /> <br />QUANT ! TY <br /> <br />DUE $0 -o <br /> <br />R!EC:¢TVED ov c,-~ ~'¥P~. CK <br />~ THIS T~ <br /> .~ A VALZD PERNIT * THIS ~ERIVIIT EXPIRES 180 ¢)AY'S FRE~ ~TS ISSUE DATE_ IF <br />CONSTRUCTION CEASES FOR A P~RIOD OF ~ 80 BAYS, O~, IF CO~STi~JCTION FALLS TO ~EET ALL <br />S~LL~EOUIREMENTSBEcOME NULL ANDOF STAT~ VO~o.LA~ ANO MARION C~OLINTY BUIldING, ANO ZON~N~ ORDINANCE. S. %flIS PER~,~T <br /> <br />OFFICE COPY <br /> <br /> <br />