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SENATOR BLDG. NO. 2~5 <br />220 HIGH STREET NE <br />SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am perform~n9 work on ~ property I own Or mcoupy. <br /> larT~a registered builder OR( ) the authorized representative <br /> of a registered builder, <br /> The work will be performed by a r¢gistered builder, <br /> Other <br /> I have read 8nd agroe to ~he term8 stated on the reverse aide of <br /> this documen~ <br /> DATE.* 03/09/91 TIME= 10:13:34 <br /> <br />OWNER: GROFF, VEI:~4 <br /> <br /> 11723 VCARaLER L/UNE <br />AURORA <br /> <br />OR 97002 <br /> <br />NE <br /> <br />SIGNATURE OF APPLICANT; <br /> <br />DATEZ <br /> <br /> f~X LOT: O^TE~ORY: RE~I DEN'T' iAL <br /> <br /> 5-N ~1 <br />'"'"'/ iO~e: i bCCUpANT LOAO: <br /> f{~R,~ON COUNTY i NO <br /> <br /> RESiDENTiAL ACO~RY STRUCTURES <br /> <br /> O~TU~ <br /> <br />~E; ?68-5058 ~ 8I TE NU~ER: 10354 <br /> VALUAI' [ ~: $2,2 <br /> <br /> SECTION: 33 TOWNSHIP: <br />LOT: ? BLOCK: Ff~N~; ZONE: MAP: <br /> <br />TYPg: BUi"LD[NG <br /> <br />CONTRACTOR, NO. <br />GROFF, <br /> <br />ARCHiTECT/ENOtNEER, NO. <br /> <br />PHONE: 788~5050 <br /> <br />BUILDING FEE <br />PLAN REVIEW <br />FLEET SURCHARGE -ZONE <br />BUiLDINt3 STATE SURCHARGE <br />Z~NING SURCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: P~ <br /> <br />PHONE~ <br /> <br />C)JANI' I l'Y <br /> <br />TOTAL ,, <br />PREY[ODS RECEIPTS <br />THi$:RE(;EtPT <br /> <br />.gB~3UNT <br /> [38.50 <br /> 25.03 <br /> $7.68 <br /> 1.93 <br /> $1~93 <br /> <br />$o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br /> I'yPE~ ONECK ~: 0 <br /> IF' <br /> <br />THiS IS A VALID PERMIT ~ :THis PEf~IT EXPIRE~ 180 DAYS FRO~I iTS ISSUE DATE. <br /> <br />CONSTRUCTION CEASE.~ FOR APERIODOP 180 DAYS, OR IF CONSTRUCTION FAILS TO ~EET ALL <br />REQUiRE~IENI'S OF STATE LAW~ AND r~ARIONCOLiNTy BUiLDiNG ANDZONING ORDINANCES, 'f'HJS PERMIT <br />~ALL BEC~E NULL AND VOID. <br /> <br />FORM # MC 15-¢ REV. 4/90 OFFICE COPY <br /> <br /> <br />