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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 RM. - 8:00 A.M, <br /> <br />DATE.* 06/25/89 TINE** 2:40:43p <br /> DORAN, TOM <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> DATE: __ <br /> <br />TAX LOT: <br /> 90061-461 <br />CONSTRUCTION TYPE; <br /> <br />CA'f EGORY: <br /> RESIDENTIAL <br />OCCUPANCY; <br /> <br /> 910 HAZEL <br />AUMSVILLE OR 97325 <br /> <br /> CONTRACT CITY: UGS: <br />AUIv~VI LLE NO <br /> <br />OGGUPANTI.GAC: <br /> <br /> NO. OFBEDROOM$ <br /> <br />MAILING ADDRESS: <br /> <br />PO BOX 185 <br />SUBLIMITY OR 97385 <br />PHONE= 769-?354 <br /> <br />10 5 25 <br /> ?0 116 8120.00 <br /> <br />GILDOW II <br /> <br /> SITE NUI'4BER: <br /> VALUATION <br /> RANGE; <br /> <br />8S 2N <br /> IRREG, LOT: <br />SF NO <br /> <br /> 7678 <br /> <br />ZONE: MAP: <br /> <br /> RI 51 <br />CORNER: <br /> <br /> NO <br /> <br />TYPE: PLUMING <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 312 <br />EMERY & SONS CONST. <br />PO BOX 398 <br />STAYTON, ORE 9?383 <br />PHONE: 769-7751 <br /> <br /> ITEM <br />WATER ,LINES, 1ST 100 FEET <br />SEWER LINES, 1ST 100 FEET <br />FLEET ,,~URCHAR~E -ZONE 3 <br />PLUIV~ING STATE SURCHARGE <br /> <br />16957 <br /> <br />;EOT, AL ,,A,~: FEES' <br />PREVIOUS R~EI PTS <br />THIS RESET OT, <br /> <br />QUANTITY A~NT <br />I $20.00 <br />1 $30.00 <br /> $3.84 <br /> $2.50 <br /> <br />~56.34 <br /> 56.34 <br /> <br />8ALANCE"0UE $0.00 <br /> <br />PAYEE: <br />RECEIVED BY; P~ <br /> <br />* THIS IS A VALID PERMIT <br /> <br />CONSTRLICTION CEASIBS FOR A <br />REOUIREI~IENTS OF STATE <br />,..~"I/[LL 8ECQf4E NULL <br /> <br /> INVOICE NO: <br />'TYPE:. CHECK <br /> <br /> ITS ISSUE DATE. IF <br /> , OR'IF OONSTEUCTION FAIL~ TO MEET ALL <br /> 8UILDIN8 AND ZONING ORDINANCES. THIS PERMIT <br /> <br />REMARKS: WATER/SEWER LINES <br />DONALD E. NOODLE"Y, MARION COUN'FY BUILDING OFFICIAL / BY ..... ,,..,L_,~/~_' <br /> ¥ <br /> <br />FORM # MC i5-56 REV 1~/88 OPFICE COPY <br /> <br /> <br />