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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 aM. - 8:00 A.M. <br /> <br />I am a regIS ered bu der OR the author zed representative SIGNATURE OF APPLICANT: <br />OIa registered builder. <br />The work will bO performed by a registered b~Jildor, <br />Of her <br />I have read and agree to the terms stated on the reverse side of DATE: <br />this document. <br /> <br />OWNER: TAX LOT: UATEGORY: <br /> DATE: 10/18/89 TIME: t0:t5:04a <br /> <br />s~usAoom~ss;,,.AKEWOOO UTILITES LTD CONSTRUC~ONTYI2E: OCCUPANCY: <br /> <br />COMmERC ~r AL <br /> <br />!328cj DAIQUIRIE LAKE DR <br /> <br />9?002 <br /> <br /> CONTRACT CITY; UCB: <br /> <br />MARION COUNTY NO <br />SUBDIVISION: <br /> <br /> SALF-N, OR 97309 <br />LoTPHONE, 244'~L40~ '1 <br /> <br /> SITE NUMBER; <br />~ANG~,ALUATiON: ZONE: <br /> <br />8840 <br /> <br />MAP: <br /> <br />WIDTH: DEPTH: AREA: UNITS; IRREG LOT; CORNER: <br /> <br />NO bio <br /> <br />TYPE': PLUMBING <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 35063 <br />E A SACK, HoE <br />5255 MACLEAY RD SE <br />SALEM, OREC-~ 97301 <br />PHONE: 364-'6685 <br /> <br /> ITEM <br />WATER LINES. 1ST 100 FEET <br />WATER LINES, EA_ A00L. 100 FEET <br />FLEET SURCHAR'~E -ZONE S <br />PLUMBING STATE SURCHARGE <br /> <br />PAYEE: STEFFGEN, MICHAEL <br /> <br />19884 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />~.,~ANT I TY AMOUNT <br />1 $20.0D <br />3 $45. O0 <br /> <br /> $3_25 <br /> <br />$75.93 <br /> ~0.80 <br />$75.93 <br /> <br />BALANCE DUE $0.00 <br /> <br />~ECEIPT NO: 20894 <br /> <br />RECEIVED BY: c] .................... TYPE: C~ CHECK ~: 34? <br />* THIS IS A VALID PERMIT ~ THIS.~EI;~2,1IT EXPIRES 180 DAYS FaCIal ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR ZF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREI~4ENTS OF STATE LANSANDI','tARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PERNiT <br />SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: 400 FT ~L FROM 13269 DAIQUIRIE TO t3407 OIAMOND LAKE CT <br /> <br /> NOODLEY, MARION COUNTY BUILDING OFFICIAL / BY ..... ~.~ .................... <br />~)NALD <br /> E_ <br /> <br />FOaM ¢¢ MC ~5-b~ REv. 11/88 OFFICE COPY <br /> <br /> <br />