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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 8::00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br /> Othar ...... <br /> I ha~e read and agree to the terms stated on the reverse side of <br /> <br />DAIE: '~2/18/90 1'~fflls: 13.'53~35 <br /> HERR~C4N, ROY <br /> <br />SITUS ADDRESS <br /> <br />SIGNATURE OF APPLICANT <br /> <br />CATEGORY <br /> <br /> 92?3 ~AW ~)UARE RD <br />AUf~V~ LLE OR 97325 <br /> <br /> CONTRACT CITY UGS <br />f~AR J. ON CC~IN f'y NO <br /> <br />MAIL'NC= ACOREBS ~(J/~Y/~ ~1 ~..~'~ SUBDIVISION <br /> / <br /> DESiR~E H~R~N/- ~iLE <br /> 9254 ~ ~R~ RD SE ~V~LLE <br /> ~ONE: 364-1~33 SiTE NU~ER: <br /> VALUA T I ~: <br /> <br />LOT BLOCK ~ION TOWNSHIP ~ANGE <br /> 13 8S 2W <br /> <br />OCCUPANT LOAS <br /> <br /> 3 <br /> <br /> 11510 <br /> <br />ZONE MAP <br /> AR3 49 <br /> <br />CORN~ <br /> <br />TYPE: MO~JLE HOt'CIE PEI;f~J.'t OR APPL,~CATiON NO: 9029398 <br /> <br />CONTRACTOR, NO. 38238 <br />,!~ANfi/~I FC081L~ HOC4E3 <br />11373 M[L~REEK RD SE <br />~ViLLE OR 9?325 <br />~: 769-7?44 <br /> <br />QUANT ~ FY <br /> <br />IIOTAL A3SESSED FEB <br />PRC¢ f OUS RECE[ P rs <br />|FILS RECE [ PI' <br /> <br />AMOUNT <br /> $89.25 <br /> $15.75 <br /> ~5.25 <br /> 3,84 <br /> $5.25 <br /> <br />$119,34 <br /> $0.00 <br /> <br />BALANCE [L~JE $0.00 <br /> <br />PAYEE: 86rIT'Y JOHN$'~OI~ RECEIP'T 31062 <br />PJgOE[VEO 8Y: PR__~_,./c..(,~._ tYPE: CK CHECK ~: 1454 <br /> <br />:¢ THIS 15 NOT A PERI,lIT, THIS APPLICATION NL~T ~ TH~ A ~[~ P~ ~ERE THE <br />FOLL~[~ ~T BE ~LETEO. [T [~ THE ~S[8[L[TY OF THE ~PL[~T TO ~RE THAT <br />ALL NEC~A~ [N~TI~ H~ BE~ P~ID~, <br /> <br /> REMARKS: ~I~E-H~E PLAC~ENI='-RAR~iP ~3447 <br /> <br /> OFFICE COPY <br /> <br /> <br />