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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 - 43o <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />I am perforITlir~9 work on 8 property I own or occupy <br /> <br />Ct a reg~sfered builder <br /> <br />owF:C~fE: 10/22/90 f'[ME: 13:51i03 <br />51TUS ADDRE~LLIO~ ' HARDY <br /> <br />TAX LOT CATEGOPY <br />CONSTRUCTION TYPE 90080~ 9~ OC~.UPANCY <br /> <br />R~-S.I D~.i'4 ¥ 1AL <br /> <br /> 286 3RD 5f <br /> AUMSVi LLE <br />USE OF 8UILDING <br /> <br />OR 97325 <br /> <br /> CONTRACT CITY 5~B OCCUPANT g~ <br />AUM~Vi LLE NO N¢ 0F ~[m~,::,,::,M~ <br /> <br />MAILING ADDRESS SINGLE FAMILY 0NELLiN6~ <br /> <br /> 1100 CHEMEKEfA Nig ~102 <br /> SALEF4 97301 <br /> PHONE: 581-1020 <br />LOT BLOCK <br /> <br />SECTION TOWNSHIP <br /> <br />SUBDIVISION <br /> <br /> MERRIF~EL~ <br /> <br /> S~'IE NUrCE3ER; 11540 <br /> ~AN~k/~LUAf~ON: ZON~ $1,805.3~A~ <br /> <br />WIDTH 4 DEPTH 4 AREA ~5 UNITS ~ IRPEG LOT ~ CORNFR ~ 5J <br /> <br />fYPE: WUiLOiNG <br /> <br />PERMIF OR APPLiCAFioN NO; <br /> <br />BUiLOiNG <br /> <br />BUiLOING ~[AIE <br /> <br /> 9028221 <br />AN-%:HIfECT/EN~INEER, NO. <br /> <br />TOTAL ASSf~EO FEES <br />PRBWIOU$ RECEIPIS <br />THiS RECE~Pi <br /> <br />AIV~UNI <br /> ~31,OO <br /> 20.~5 <br /> $3.84 <br /> <br />$56_54 <br /> <br />  E DUE $0+U0 <br /> PAYf3E: INfP. GR~( fY C'ONSfN1.JC'FION 29821 <br /> REC~iVbO BY: OM2 TYPE: iN CHECK ~: 0 <br /> <br />· fill5 IS NOt A PERMif. THi~ APPLiOA[iON MUST GO THROUGH A RFA/IEN PROCESS NH~-RE file <br />POLLONiNG MUSi BP. COMPLE]fED. i] iS ]HE RESPONSiBJ;Li[Y OF THE APPLICANf 'fO A~:k."-,URE ~RAf <br /> <br />ciIY JURISDiC~ION: BY OAIE <br /> <br />AL.L NECE~RY iNPOR~Af ION HAS BEEN PROViOE0. <br /> <br />5~PflC: BY ........ DAT~ ............ <br />~ONiNG~ 8Y DATE SE'IBACK~: PR <br /> <br />HEl~fll: IOIAL ~ Flt 0 S'IORI~S: <br /> <br />LS K~ RR 5P <br /> <br />PLAN.ACIiON: <br /> <br />OFFICE COPY <br /> <br /> <br />