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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 /> N~ ' CONTRAOT 0 TY ] U~ , <br /> 11733 NA~LER ~E 'J :' : <br />~RO~ OR 97002 ~ ' ' :. <br /> <br />MAILIN~ ADDRESS: <br /> <br /> 6845 SN NYBEG RD <br /> TtJAUALT f N, ORE <br /> <br />LOT: SLOCKr <br /> <br /> : ................... 8EN'TURY"MEAt~'"'PARK'4'TH"ADD <br /> <br /> ! SITE NUf4BERt 4996 <br /> <br />119 %~0,-OO J SF'; NO .; NO <br /> <br />TYPE: PLU~8ING PER~IT OR APPLICATION NO; <br />CONTRACTOR. NO. ~ <br /> <br />~IL~K~E, ORE~ 9?222 <br />PH~E: <br /> <br />NATER LIN~, 1ST 100 FEET <br />SEWER LINES, 187 100 F~ET <br />~ILE H~E S~ER ~D NATER C~NEOTION <br />PLUMING BASE FEE , :, <br />FLE~ ~HA~E -Z~E 6 <br />PLUMING STATE SU~HARGE <br /> <br />9009961 <br /> <br />QUANTITY <br /> 1 <br /> 1 <br /> 1 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOtJS RECEIPTS <br />THIS RECEIPT <br /> <br />ANOUNT <br /> $20.00 <br /> ~30.00 <br /> 25.00 <br /> <br /> .75 <br /> <br /> $o.oo <br /> $86.43 <br /> <br />PAYEE: ABRAHAM FACTORY HOIvfES: INC/i~ON: ,, : RECEIPT NO: 10647 <br />RECEIVED 8Y: cl ,: :/,¢' ~:~, ~PE: CK CHECK $~: 23?8 <br />* THIS I$ NOT A P~lT. ~IS APPbI~TI~ ~T ~ ~ A R~I~ P~ ~ERE ~E <br />FOLDING ~ST BE ~L~ED. IT'"IS,~E R~8IBIEI~ OF ~E APPLI~T TO ~RE ~T <br />ALL NEC~ IN~TI~ H~:)BE~ P~IDED. <br /> <br />PLAN REVIEW: 8Y ......... DATE .......... <br /> <br />RFJ~ARKS: MH CON, WL,SL R~4167 <br /> <br />CITY JURISDICTION: BY <br /> <br />BATE <br /> <br />.o~ ~* M~: ~5.~6 ~v ~/~7 OFFICE COPY <br /> <br /> <br />