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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALBM, ORBGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am perfo[m~n9 work on ~ property I own or occupy <br /> I am a registered bu0der OR the author zed represon ave <br /> of 8 reolstered ,builder, <br /> The work wdl bt~ podorrned by a registered bu Ider, <br /> Other <br /> J have read and 8Dree to the terms stated on the reverse Side of <br /> <br />DA'rE: 01/23/91 'rIME: 11:57:53 <br /> DAHL, ROt8 ERT <br /> <br /> 5932 VILLAGE ViEW CO. JRT <br />AUMSVtLLE OR 97325 <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE· <br /> <br /> TAX LOT <br /> <br /> GONSTRUCTfON TYPE <br /> <br />GONTRAC¥ 01¥~ LJGS <br />MARl ON C~N1'Y NO <br /> <br />PO BOX 1457 <br />CEDAR CITY. UTAH 94'120 <br />PHONE= 801-586-8081 <br /> <br />LOT: $1.OGK' SECTION TOWNSHIP <br /> 13 <br /> <br />VILLAGE VIEW <br /> <br />SiTE NUMBER ~. 9985 <br />VALUAT i(3N: <br /> <br />AC <br /> <br />RREG LOT NO CORN~i~O <br /> <br />CATEGORY: <br /> RE$I OF.~')IAL <br /> <br /> NO OF BEDROOMS <br /> <br />MAP: <br /> <br />TYPE: ELECTRICAL PER~I~II'F OR APPLiCATiON NO= <br /> <br />23514 <br /> <br />CONTRACTOR, NOi <br />LiCb,~SE NO: <br />DAHL, ROBER'I' <br />PO Box 1457 <br />CEDAR CITY, UTAH 94?20 <br />PHONE: 801-586-8081 <br /> <br />ECJPERVlSING ELE~'I'RICIAN/NUMBER <br /> <br /> ITEM <br />I~q(Y~iLE HONE CONNECTION <br />FLEET ,,SURCHARGE -ZONE 3 <br />ELECTRICAL STATE ECJRCHARGE <br /> <br />(~t,IAN'I'ITY At,'E,~JNI' <br /> 1 $25.o0 <br /> $a.84 <br /> $1.25 <br /> <br /> TOTAL ASS~ED FEES $30.09 <br /> PREVlOUBRE~EiPT$ $30.09 <br /> THIS RECEIPT $0,00 <br /> 8AL,~NCE I~E $0.00 <br />PAYEE: INVOICE NO: <br />RECEiVEO BY: CL TYPE: CHECK ~: 0 <br />THiS IS NOT A PEI~IIT <br /> <br />RE~4ARK~: REP~ND OF UN-i,SE~ED APPLICATiON <br />DONALD E. ~X)DLEY, rflARiON COUNTY BUILDING OFFICIAL / BY ...... ~ <br /> <br />FORM # MD 15-56 REV, 4/90 OF FIDE COPY <br /> <br /> <br />