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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:: 588-8147 8::00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />Other. <br /> <br /> have read and agree to fhe terms stated on the reverse Sido of <br /> <br />DARE: 10/30/90 rIME: 10:57:ol <br /> SELDEN, PAUL <br /> <br />S~TUS ADDSbSS <br /> <br />DATE <br /> <br /> 12021 FARGO RD NE <br />AURORA OR 9'1002 <br /> <br />USE OF BUILDING <br /> <br /> CONTRACT CITY UGB <br />fAARION COUN IY NO <br /> <br />MAILING ADDRESS <br /> <br />SUBDIvISiON <br /> <br />~ 8OX 413 PAR(gO TRAILERS <br />AURORA OR 9?002 <br />PHONE: 8?8-5484 <br /> <br />LQT BLOCK SECTION <br /> <br /> TOWNSHIP <br />O4 <br /> <br />1 . 5 HNITS <br /> <br /> 5I]E NUMBER: <br /> VALUAFION: <br /> <br /> PANGE <br /> <br />AC IRREG LOT NO <br /> <br />RESIOENIlAL <br /> <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br />ZONE MAP <br /> <br />IYP~: ~)~iLE HOfAE PERMIT OR APPLICATIDN NO: <br /> <br />28316 <br /> <br />CONFRACFOR, NO. <br />~ELDEN, PAUL <br />F,'O BOX 413 FARGO fRAiL~R~ <br />AURORA OR 97002 <br />PHONE: 678-5484 <br /> <br />FLEEr SURCHARGE -ZONE 4 <br /> <br />QUANTI1Y AMOUNI <br /> $5.12 <br /> 1 $25.0O <br /> <br />TOTAL ASSE~EO FE~',~ <br />PREVIOUS RECEIPTS <br />FH[$ RECEIP'f <br /> <br />$30.12 <br />$30.12 <br /> $o.0o <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: RECEIPF <br /> RECEIVED BY: CL I'YPE: CHECK ~: 0 <br /> <br />* THiS iS A VALID PEF~iT * THiS PER~¥tiT EXPiRE~ 180 DAYS FRON irs ISSUE DATE. IF <br />CONSTRUCT[ON CEA.S~.'TA POR A PERIOD OF 180 DAY~,OR iF ~ST~CT[~ FA[~ TO ~EET ALL <br />R~[RE~S OF ~TATE ~ ~D ~Rt~ ~NTY BUILDING ~D Z~[N~ ORD[N~C~, TH[~ PE~[T <br />~ALL B~E NULL ~D ~iD+ <br /> <br />SEI'BACK~: FR 20 LS 10 R~ 10 RR 30 SP <br />REI~ARKS: ~'f'ORAGE PSRt, IIT ~EY. lO REPAIR ~lCE R~3~03 <br /> <br />P~NNiNG ACf ION: ~,~N~ OCC~p~ ~ <br />[~ALO E. ~ODLEY, ~ARiON C~NIY BUILDING OFPICiAL / BY <br /> <br />*APPROVED FOR ~IORAGg <br /> <br /> OFFICE COPY <br />FORM # MC 16-56 REV 4/90 <br /> <br /> <br />