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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 PM - 8::00 AM <br /> <br />DATE: <br /> <br /> OWNER <br /> <br />~ sm performln9 work on ~ property l own or occupy <br />I am a registered builder OR ( ) the ~uthorized representBtive <br />of a registered builde~ , , <br />Other <br /> <br />this document <br />03/15/89 TIME: 9:49:36a <br /> <br />SIGNATURE OF APPLJCANT <br /> <br /> DATE: <br /> <br />FMHA TAXLOT 90061--261 <br /> <br />C^'mGOR¥ RESIDENTIAL <br /> <br /> 910 LINCOLN ST <br />AUMSVI LLE OR 9?325 CONTRACT CITY UGB <br /> AUMSVI LLE NO <br /> <br /> USE OF BUILDING <br /> <br /> MAILING ADDRESS SUBDIVISION <br /> GILDON ~2 <br />1655 25TH ST SE <br />SALEM OR 97902 <br />PHONE*. 399-5751 SITE NUMBER: 5824 <br /> VALUAT ION: <br /> <br />LOT BLOCK i SECTION ~WNSHIP RANGE ZONE <br /> 10 3 25 8S 2W RS <br /> <br />W~DTH 8? DEPTH: 97 AREA UNITS SF IRREG LOT YES coT: <br /> <br />MAP <br /> 51 <br /> <br />TYPE: PLUMBING <br /> <br />CONTRACTOR, NO. <br /> <br />1655 25TH ST SE <br />SALEM OR 97302 <br />PHONE: 399-5751 <br /> <br /> ITEM <br />WATER LINES, 1ST 100 FEET <br />SEWER LINES, 1ST 100 FEET <br />FLEET SURCHARGE -ZONE 3 <br />PLUMBING STATE sURCHARGE <br /> <br />PE~IT OR APPLICATION NO: <br /> <br />~44o0 <br /> <br />TOTAL ASSE;SSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br />t $20.00 <br />1 $90.00 <br /> $3.84 <br /> $2+50 <br /> <br />56.34 <br />$0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: INVOICE NO: <br /> <br />RECEIVED BY= c] ............ ............. TYPE: CHECK ~: <br /> <br />· THIS IS A VALID PERMIT ~ THI~ PE,f~IT EXPIRES 180 DAYS FROM [TS IS.SUE DATE. [F <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS. OR I~F CONSTRUCTION FALLS TO MEET ALL <br />RE(~.JIREMENTS OF STATE LAt~ AND MARION COUNTY BUILDING .N~ID Z'ONING ORDINANCES. THIS PEt~IIT <br />SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: W/S LN 100FT <br /> <br />DONALD E. NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM # MC16-68 REVll~88 OFFICE COPY <br /> <br /> <br />