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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 588z8147 <br /> CODE-A-PHONE'4;30 P.M, - 8:00 A.M, <br /> <br /> I am performing work on n property I own or ocoupy, <br /> <br />[)A'~'~':: 67/06/87 TIME: !'i:55:49~ <br /> 8R,-,GH'F, JAMES ;,~ <br /> <br />SITUS ADDRESS'. <br /> <br /> DATE; <br /> <br /> TAX LOT; <br /> <br />' CONSTRUCTION TYPE: <br /> <br /> 20692 OUV'~STEAD :?[ NE CONTRACT CITY DGS <br />AdRORA OR 97002 <br /> <br />· ,:;.A ¢l'z <br /> <br />D'HON E: 6'78--'15 1 g <br /> <br />LOT' BLOCK' SECTION TOWNSHIP ' <br /> <br />WIDTH' DEPTH: AREA: JNITS; <br /> '" 0 {'; gOC 350000. <br /> <br />OCCUPANT LOAD <br /> <br /> NO OF 86~R00MS <br /> <br /> STTE NUMBER: VALUATION <br /> <br />4, S <br /> <br />SF <br /> <br />9503013 <br /> <br />HATER SUPPLY: F~ <br />TEST HOLES READY: <br />SITE EVALUATION NUIV!BER: <br />EXISTING TANK S;ZE: <br />E><;BT~NG DRAIN F;EL.D <br />SEPTIC TANK PLJMPEb: <br />PREVIOUS NC. ~OROO~'S: <br /> <br />; , E, OUAN T; ,TY AMOUNT <br /> <br />T:OTAL A~ESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br /> INVOICE NO: <br />TYPE: CK CHECK ~:: <br /> <br />SYSTEM, <br /> <br />PAYEE: BRIGHT, JA,~vIEs <br /> <br />SEE ATTACHED DOCUMENT FOR <br /> <br /> $0,00 <br /> $35,00 <br /> <br />3532 <br />3]36 <br /> <br />A REVIE~ PROCE~ ~HERE THE <br /> THE APPLICANT TO ASSURE THAT <br /> <br />* THIS IS NOT A PERNIT. THIS <br />FOU~DNING I~JST BE 6ONPLETED. <br />ALL NEC~RY INFORMATION <br /> <br />PLAN REVIENi BY <br />REMARKS: DR.,~h ,.~:~O ?AtL.~N8 <br /> <br />,,,,~v, DATE <br /> <br />OFFICE COPY <br /> <br /> <br />