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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 />0A'T E: <br /> <br /> OORAN, 'I <br /> <br />rlME: 13:33=55 <br /> <br /> · ,890 8IH Sf <br />AtJfcCSVILLE OR 9?325 <br /> <br />TAX LOT <br /> 90040-4?0 <br />CONBTRUCTiON TYPE <br /> <br /> 50N <br /> CONTRACT CITY iJG~ <br /> <br />AUI~V l LLE NO <br /> <br />CATEGORY <br /> <br /> RE.~i DEN f ,'[AL <br /> <br /> R~3 <br /> <br />MAILiNGADDR~SS SINGLE PANILy ONELLINfg,% <br /> <br />PO SOX 185 <br />~BLiMiiY OR 9?386 <br />PHONE: 769-7364 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br /> 6 8 25 8S <br /> [4 95 7030. SF <br /> <br />SUBDIVISION <br /> <br />$I1E NUMBER; 11857 <br />VALUA l- iON .* $29,500.00 <br />RANGE ZONE MAp <br /> <br /> 2~ <br />IRREG LOT CORNER <br /> NO NO <br /> <br />lYRE: BUILDING PER~II'F OR APPLICATION NO: <br /> <br />29108 <br /> <br />C;ON1RACfOR, NO. 5549,~ <br />f r,2NI DORAN <br />PO BOX 185 <br />SUSLiMi FY 9?385 <br />PEON F.,.: '! 69 - 7,354 <br /> <br />ARCH I 1 ECl/ENGINEER, NO. <br />PHONE: <br /> <br /> IT'EN <br />BUILDING FEE <br />PLAN RF,¥ t E.~! <br />FLEf':'I ~URCHARGE -ZONE 3 <br />BUILDING ~FA['E SURCHARGE <br /> <br />QUAN FIlY <br /> <br />Ar,~LJNI <br /> $193.00 <br /> $125.45 <br /> <br /> $9,65 <br /> <br />FO'fAL AS.S.~ED FEES <br />PRB¥IOUS RECEIPFS <br />IHIS RECEiR1 <br /> <br />$33/_94 <br />$391_94 <br /> $o,oo <br /> <br />BALANCE DUE $0.09 <br /> <br /> PAYEE: <br /> RECEtVgD BY: PR 'TYPE: CHECK ~: 0 <br /> <br /> * IHl$ iS A VALID PERMI1 * I'Hi8 PER)Mi1 EXPIRES 180 DAYS FROM l'i~ I~SUE <br />CONSfRUCFiON CEASES FOR A PERIOD OF ~80 DAYS, OR i¢ ~T~CFi~ FAILS rD MEEf ALL <br />RE~IR~N1S OF SLATE ~ AND ~Ri~ ~NIY BUILDING ~D Z~iNG ORDIN~CES, IHiS PE~iI <br />~ALL BEC~E NULL ~O <br /> <br />~EIBACKS: PR 20 LS 5 ~ 5 RR 5 SP <br />RE]VlARKS: NEW'RES ........... <br /> <br />HEIGHI: 14 TO1AL ~ PI: 1181 SIORiES: 1 <br /> <br />DONALD E. NC~DLE¥, F,1ARION CCXJNFY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />