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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 P,M. - 8:00 A-M. __-.,~-'~ <br /> <br />DATE: 04/17/'87 Ti'~'~: [0:23:30a <br /> <br />OWNER; <br /> BERGERSON, ROGER M & PAULINE C <br /> <br /> 9833 W. STAYTON RD SE <br />AUMSVILLE OR 97325 <br /> <br />RF, SID~ ACCESSORY STRUCTURES <br /> <br /> TAX LOT: ~ CATEGORY; <br />~,/..,-,-q.S/- O~ H 61352-000 R <br />CONSTRUCTION T~PE: OCCUPANCY· <br /> <br /> OCCUPAN LOAD <br /> CONTRACT CITY UGS ' '. <br /> <br />SU~C VISION <br /> <br />SAME <br /> <br />PIiONE: 749-2561 <br /> <br /> J 3,88000 <br /> <br /> SITE ~: <br /> VALUAT I ON: <br /> <br />9S 2W <br /> <br /> 1114 <br /> $7,128.00 <br /> <br /> EFU 62 <br />CORNER· <br /> N <br /> <br />CONTRACTOR, NO, <br /> <br />PEI:~ttT OR At~LICATION RD: <br /> <br /> 9001647 <br />A~CHITECT/~GINEER, NO. <br /> <br /> ITS~ <br />BUILDING FEE <br />PLAN REVIEW <br />Fr.~w~ SURCHARGE -ZONE 3 <br />STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />PAYEE: BERGE~SON, ROGER M a PAULINE C <br />RECEIVED BY: cr <br /> <br />* THIS IS NOT A P~RMIT. THIS <br /> <br />ALL ~ INFO~TION ~ __ <br /> <br />SEPTIC: BY <br /> <br />ZONING: <br /> <br />PHONE: <br /> <br />QUANTITY ~ <br /> ~68.50 <br /> 44.53 <br /> I3.84 <br /> 2.74 <br /> $3.43 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$123.04 <br /> $o.oo <br />$123.o4 <br /> <br />BALANCE DUE <br /> <br />$0.00 <br /> <br />INVOICE NO: 2138 <br />TYPE: CA C~I~#: 0 <br /> <br />APPLICANT TO ASSURE THAT <br /> <br />BY DATE <br /> <br /> Rs- /z~/ ~1%,,,,,~0 / <br /> <br />OFFICE COPY <br /> <br /> <br />