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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 />Other_ <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />OWNBA{E; 04/01/91 riME... <br /> <br /> MOORE, ~LBY <br />SIfUS ADD~ESS <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TY¢'E <br /> <br />CATEGORY <br /> <br />OCCUPANCY <br /> <br />RESI UEN t' iAL <br /> <br /> 205 EVERGREEN OR <br />AUMSV 1 LLE <br /> <br />OR 97325 <br /> <br /> CONTRACT CITY <br /> <br />AUI~ViLLE <br /> <br />UGB OCCUPANT LOAD <br /> <br />SUBDIVISION <br /> <br />EVERGREEN rcfJSt. LE HOf~IE PARK <br /> <br />LO/ BLOCK SECTION TOWNSHIP <br /> <br />SI{E NU~lBER: <br />VALLIA] iON ~ <br />RANGE ZONE <br /> <br />11801 <br /> <br />MAP <br /> <br /> CORNER <br /> <br />NO . NO <br /> <br />IYPE: P!.JJIW¢ING PBR~4I f OR APPLICAtiON NO: 31267 <br /> <br />CON1P.,AC'IOR, NO. 43465 <br />BOB'S rcf.:,lBILE '~ET UP <br />14.262 :~. I~.APLEGROVE <br />NOLLALA, ORE~ <br />~E: 829-6983 <br /> <br /> i FEN <br />1~08ILE HCY4E SEWER AND WATER CONNEO'rtoN <br />PLUMING 5'lA'l E ,St~ROHARGE <br /> <br />~ANIIIY <br /> 1 $25.00 <br /> <br />TOTAL ASSE~5~ED FEE~ <br />PREVIOUS RECEIPTS <br />THiS RE"CEIPf <br /> <br />$26.25 <br />$26.25 <br />$o_oo <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: INVOICE NOt <br /> RECEIVED BY: gL 'TYPE: CHF-.,C-K ~: 0 <br /> * THI~ IS A VALID i>ERI~IlT ~ TH~S PEi;~ilT EXPIRE~ 180 DAY~ FROt4 ITS I~tSUE DATE. IF <br />CON~TI~JCTION CE.A~ES FOR A PERIOD OF 180 DAY~, OR IF CONSTRUCTION FAII.~ TO I~EET ALL <br />~R~IREI~E~TS OF STATE ~ AND I~RION COUNTY BIJILDIN~ ~ND ZONiN~ ORDIN~N~ICE~, THI~ PER~4iT <br /> ALL BEK~O~ENULL AND VOID+ <br /> <br />REMARKS: f4-1 CON <br /> <br />DONALD E. NOODLEY, ~IARION COUNTY BUiLDiNG OFFICIAL / BY .................................... <br /> <br />FORM # MC 15-56 BEV 4/90 OFFICE COPY <br /> <br /> <br />