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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: 588-514'7 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />owN~:fE~ 05/30/9'8 <br /> <br />PERKINS, .OAVIB G <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />~ TAX LOTi' <br /> <br />· CONSTRUCTION TYPE: <br /> <br />CATbGOB¥: <br /> <br />OCCUPANCY: <br /> <br />RE81DENl'1AL <br /> <br /> 20813 FILBERT ST <br /> AUROP~ <br />USE DP 8UII_F)ING: <br /> <br />97002 <br /> <br />NE <br /> <br />UGB: <br /> <br />NO¸ <br /> <br />OCCUPANT LOAD: <br /> <br />LO'f <br /> <br />BLOCK: ISEGTION: <br /> <br />SITE NUfflBER: 10232 <br />VALUAT [ON: <br />RANGE: ZONE: <br /> <br />MAP: <br /> <br />UNITS: <br /> <br />NQ NO <br /> <br />TYPE: ON-SI're SE~,:IE <br /> <br />PEF,~IT OR APPLiCATioN NO: <br /> <br />C'ONTRACTOR, NO. <br />PERK[NS. DAVID G <br /> <br />9024246 <br /> <br />WATER~UPPLY: <br />TEST HOL~'-~ READY: <br />si're EWALUATioN NUN8ER= <br />E,h<ISTINGI'ANK S[ZE: <br />~ISTiNG D~iN FIELD LIN~: <br />~EPTiC ']'~K ~MPED: <br />~RE~ I~S <br /> <br />PAYEE: <br /> <br /> ! 1'EM (~UA~41' l I'Y <br /> &, AUI'HORIZA'rloN NOTICE - FLD, VISIT 1 $105.00 <br /> TOTAL A._~SESSED FEES $105.00 <br /> PR~I~S RECEiP~ $100.00 <br /> THiS RECEIPT $0.00 <br /> <br /> 8A~CE ~E $5. O0 <br /> <br /> iNVOiCE <br /> ~RECEIVEO BY= c"l TYPEt ~ECK ~: 0 <br /> ~EE A'rT~ED ~T FOR RE~IR~ ~ ~-~I.fE S~E <br /> <br /> ~IS IS ~T A P~IT. ~IS ~i~TI~ ~T ~,~ A ~l~ P~ <br /> ~[~ ~T ~E ~. IT 1S ~E ~JBILJ~ ~ ~E APPLI~T TO ~ THAT <br /> <br /> ....... U mO CT m= .............................. 0A'r ............................... <br />~ RE~R~: ~TH- CiTY H~ APPL FOR REP~C~T FOR ~iLE H~E <br /> <br /> OFFICE COPY <br />FORM # MC 15,56 REV. 4/90 <br /> <br /> <br />