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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 />have reBd and aVree to the terms stated on the reverse side of <br /> <br />I,DwN~TE: 09/17/90 TIME: 11:4~":t9 , TA~LOT~ r <br /> ~iLLE~ ~R~ <br /> <br /> AU~ViLLE ~ <br /> <br /> OR 9?325 i , <br />............... ;I'¢~RI-ON-~Nt'Y NO !N0 0~ "EDR00MS <br /> <br /> 435 N. MACY ST <br /> I~CMINNV [LLE, OR 97128 <br /> PHONE,* 472-7618 SiTE NU~I~ER: 110'75 <br /> VALUAI I ON: $1,848.00 <br />LOT' 8LOOK'. ! SECTION i YGW~Rt¢~i RANGE; ; ZONEr MAP: <br /> <br /> ~ -*$ 8S ' gN CR <br /> ! OOO,: !,N0 :' NO <br /> <br />49 <br /> <br />TYPE: BUILDING PER~iT OR APPLICA'1'iON NO: 25551 ~ <br /> <br />CONTRACTOR. NO. <br />MILLER, JERRY <br />435 N, ~CY ST <br />rcF~MINNVILLE, OR g7128 <br />PHC,,~NE: 472-7818 <br /> <br />ARCHi'f'E~T/ENGINEER, NO. <br />PHONE: <br /> <br /> iTEM <br />BUILDING FEE <br />PLAN REVIEW <br />FLE6T SURCHARGE -ZONE <br />BUiLDiNG 8'I'A'T'E f~LJRCHAR~£ <br />ZONING SCJROiARGE <br /> <br /> QUcNNTiTY AMOUNT <br /> <br /> $20.15 <br /> 5 12 <br /> <br /> $1.5~ <br />::: O AL,ASS D FE S 59. 'r <br />: RECEIPTS $59. ~'~ <br /> f'NJSRECEiPT $0.00 <br /> <br />BALANrE[~JE $0.00 <br /> <br /> PAYEE .' <br /> RECEIVED BY; P8 : TYPE: CHECK :~: 0 <br /> <br />,K 'THIS iS A VALID PERMIT * I'H1S PEril' ~PIR~ 180 DAYS F~ iTS i~E ~I'E, iF' <br />C~S'~'~C'T i~ c~ FOR A PER~OD OF 180 DAY$ ;OR I F ~8'[~CT i~ FAI~ l'O MEET ALL <br />RE~IREMEN'fS OF' ~TATE LA~ ~D ~i~ ~NTY BUILB1NG ~D Z~IN¢ ORDtN~C~, THiS PE~i'f' <br />~ALL BEO~E NULL ~D VOID. ,' , <br /> <br /> SEfBACKS: FR * LS 2 ~ 2 RR 2 SP ~ '~ ¢ F' <br /> R~RKS: STO~G~ BE~ APP~VED"FOR PRIVATE NON~E~iAL USE ONLY. x<MU$'F BE L~A'FEB ' <br /> C~PLE'I'ELYBEHiNDR~iD~C~ ~ ~ <br /> HEIGH'F: TO'FAL ~ F'F: 308 S'FORi~: t ~_LAN.ACTION: <br /> DONALD E. ~ODLDY, ~RION C~JIJNI'Y BUILDING OFFiCiAL / BY ............................................................... <br /> <br /> OFFICE COPY <br />FORM # MO 15-55 REV. ~ <br /> <br /> <br />