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22~HIGH STREET NE <br />SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4;:30 PM - 8::00 AM <br /> <br />lamperf°rmlngw°rk°n, reperly~°wnor°ocupyl ~ ~ <br /> am a registered builder O- < I the authonzed represen a ye SIGNATURE OF APPLIOANT <br /> <br /> have read and agree to the terms stated on tho reverse side of'-- DATE .. <br /> <br /> 05/04/89 <br />ADD~ES~AKER' ALLEN <br /> <br />TIME: 8:51;12a <br /> <br />CONSTRUCTION TY~E OCOUPANCY <br /> <br />RESIDENTIAL <br /> <br /> ?'751 8I,¢¢iOP RD <br /> AUNSV I L LE <br />USE OF BUILDING <br /> <br />OR 97325 <br /> <br />SE <br /> <br /> CONTRACT CI~ U¢38 <br />~.RION COJNTY NO <br /> <br />OCCUPANT LeA0 <br /> <br /> NO OF BEDRQQMg <br /> <br />SUBDIVISION <br /> <br /> 3442 TURNER RD SE <br /> SALE~ 9?302 <br /> PHONE*. 362-9485 <br />LOT 8LOCK <br /> <br />WIDTH DEPTH <br /> <br />152 '/:21 <br /> <br />SECTION TOWNSHIP <br />AI~A ~0 UNITS <br /> <br />SITE NUMBER.* 7148 <br />RANC~ALUAT 1 ON ~. ZONE <br /> <br />8S I~E~ LOT 1~ CORNER SA <br /> <br />SF YE~ NO <br /> <br />MAP <br /> <br />TYPE: PLUMBING <br /> <br />PER~IT OR APPLICATION NO.+ <br /> <br />CONTRACTOR. NO. <br />BAKER. ALLEN <br />9442 TURNFJR RD SE <br />SALEM 97302 <br />PHONE: 362-9485 <br /> <br /> ITEN <br />WATER LI'NE~, 1ST 100 FEET <br />NOalLE HOME SE~ER AND HATER CONNECTION <br />FLEET aURCHA~E -ZONE 2 <br />PLUMBING STATE SURCHARGE <br /> <br />9015638 <br /> <br />:QUANTITY ANOONT <br />1 $20.00 <br />1 <br /> $2~56 <br /> $2.25 <br /> <br />PAYEE~ BAKER, ALLEN <br />RECEIVED BY.* BM <br /> <br />* THIS .i8 NOT A PERtKfT+ l~ <br />FOLDING I~ BE <br />ALL NEDI~ <br /> <br />PLAN REVIEW: BY DAT~,~__ <br />R~RKS'. CONN & HATER LINE R,I~749~' <br /> / <br /> <br /> TOTAL A...~SESSED EEES <br /> PREVIOUS RECE]PTS <br /> THaiS RECEIPT <br /> <br />.__ <br /> <br />$49.81 <br /> $o.oo <br />$49.81 <br /> <br />$0.00 <br /> <br />~, ~EOEIPT NO: 16609 <br />~YPE.~C~ CHECK ~: 0 <br /> <br /> PROCESS AHERE'THE <br /> ,,TI'IE~APPLiCANT TO--RE ll'lAT <br /> <br />CITY:JURISDICTION: 8Y <br /> <br />BATE <br /> <br />FORM ¢' MC 1~.~6 ,Er I~'~ OFFICE COPY <br /> <br /> <br />