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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-PHONE4'3OPM -800AM <br /> <br /> f artl porformrng worl~ on a property I own or occupy <br /> OtherJ am a reglstorod builder OR f ~ the aL~thorized, representative S GNATURE OF APPL CANT ~_~ ~ . ~ ~" ~ ' <br /> of a regmtered bulldor -- . <br /> The work w,II be performed by a registered budder <br /> <br />OWNER TRUHBULL, LARRY 'TAX LOT CATEGORY RESIDENTIAL <br /> <br /> 9068 SNODDY DR SE <br />AUMSVI LLE OR 97325 <br /> ~O~T ~'UNTY uaB NO OOGUPANI LOAD <br /> <br /> SINGLE FARILY DWELLINGS 3 <br /> <br />PHONE: 749-1372 A~w SITE NUMBER: 6595 <br /> VALUATION: $5,1 $0.00 <br /> <br />LOl RJ. OGK SECTION TOWNSHIP RANGE ZONE MAP <br /> 10 13 9S 2N EFU <br /> <br />WIDTFI DEPTH AR~A I O. 0000JNITS AC IRREG LOT NO CGHNEH NO <br /> <br />62 <br /> <br />%r'F~: oo~LOiNG <br /> <br />CONTRACTOR, NO. <br />TRUMBULL, LARRY <br /> <br />~E~,~ZT OR APPLiCATiON NO: <br /> <br /> ~G173'5'2 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: 749-1372 PHONE: <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE 3 <br />8UILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />PAYEE: TRUMBULL, LARRY <br />RECEIVED BY: PR <br /> <br />TOTAL ASS~ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QU,NNTITY <br /> <br /> AMOUNT <br /> $58.50 <br /> $38.?3 <br /> 3.84 <br /> 2.83 <br /> $2.83 <br /> <br /> $102+73 <br /> $0.00 <br /> $102.73 <br /> <br /> $0_00 <br />18446 <br /> <br /> TYPE= CK CHECK ~: 10350 <br />~ THIS iS NOT A PERCflIT. THiS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLONING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />ALL NECESSARY INFORMATION HAS BEEN PROVIDED, <br /> <br />CI'l~F JURISDICTION: BY ........ DATE <br /> <br />SEPTIC: 8Y DATE <br />ZONING: 8Y__.,,.U.J~ .... DATE__~.L~I~,¢L SETBACKS: FR- ~(~ LS-~_~Z~,~ RS-_j/.]. RR-__,_~.. <br />R~R~: ADD TO <br />HEIGHT: TOTAL ~ FT: 172 STORIES: 2 PL~.ACTI~: <br /> <br />~OR~,~C ,~,~ .~ ,,'~8 OFFICE COPY <br /> <br /> <br />