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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />~20 HiGH STREET NE <br /> SALEM: OREGON 97301 <br /> <br /> PHONE;; 588-5147 8:00 - 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I have read and agree to the terms stated on the reverse side of <br /> <br />SIGNATURE OK APP[.~CANT <br /> <br />OwN1L~ I' E :. 04/01/91 r t~lE: <br /> <br />TAX LOT CATBGORY <br />CONSTRUCTION TYPE OCCUPANCY <br /> <br />RE,~ i DgN f 1AL <br /> <br />205 EWERGREEN DR <br />AUI~SvI LLE OR 9?325 <br />BUILDING ~VJLLE 'NO' <br /> <br />MAILING ACBRESB KfOBiLE H~E SUBDIVISION 3 <br /> <br />PHONE: 3IFE NUNSER: 11801 <br /> <br />NO , NO <br /> <br />FYPE: MOt~ i LE <br /> <br />B08'$ ~ILE SEf' UP <br />14262 S. 1'4APLEGROVE <br />IvIOLI,.~LA, OREGON <br />PHONE: 829-6983 <br /> <br />tC/OBILE HONE BASE FEE <br />1~3f:~ilE HC)~4E SIAIE FEE <br />¢40~iLE HONE, SIArE ~JRCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: CL <br /> <br />PERf~IF OR APPLICAfiON NO: <br /> <br />31266 <br /> <br />QUANIIiI¥ <br /> ~89.25 <br /> 15.75 <br /> $5_25 <br /> <br />THiS <br /> <br />~110.25 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br /> iNVOICE <br />FYPE: CHECK ~: 0 <br /> <br /> ~ TBI~ IS A VALID PEI~IiT ~ THIS PER'liT ~XPIRES 180 DAY8 FROR ITS X~BUE [;lATE. <br />~ST~CTI~ C~ F~ A PERIOD OF 180 ~,OR iE ~T~CTI~ FA]~ TO ~ET ALL <br /> <br />SEIBACKS: FR 10 LS 25 R'5.10 RR 10 SP <br />RENARKS: ICH PL~CE.~IE~I -- <br /> <br />PLANNING ACfir--,~4: <br />DONALD E. NOODLEY, MARION C[~NIY BUILDING OFFiCiAL / BY <br /> <br />FORM # MC 15.56 R~V 4/~0 OFFICE COPY <br /> <br /> <br />