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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 />OwNBA rE: 05/07/91 liME: 9:54:24 <br /> <br />S~U!~AOOUeS~O~INBKI' JUDi1H <br /> <br />2080~ 0~r~o ~AD N6 <br />AU~RA OR <br />USE OF BUILDING <br /> <br /> RESIDENI iAL <br /> <br />CONTRAC 1 CITY ~ OCCUPANT <br />]~AR t ON COUNTY NO NO <br /> <br />~*~UNC, ~eU~r~S RE~iDENIIAL ACC~RY S. fIKUCTURES sueo~v~s~o~ <br /> <br />PHONE: 6~8~1105 <br /> <br />UNITS 4S <br /> ~C <br /> <br />$11E NUfClBER: 12900 <br />n^NGV~® ZONE $5, 184. 0~p <br /> <br />NO NO <br /> <br />4, <br /> <br />IYPE: BUILDING <br /> <br />CONfRACIOR, NO. <br />~DF~INSKi, JUDIIH <br /> <br />PER)~IlI OR APPLiCAliON NO: <br /> <br /> 9032030 <br />ARCHiFECF/bTNGiNEER, NO. <br /> <br />PHONE: 6Y8-1105 <br /> <br />8UILOING FEE <br />PLAN REViE~ <br />BUILDING stArE SURCHARGE <br />~r. JNING~CJ~HAf4GE <br /> <br />TOTAL ASS~gD FEES <br />PRE¥1OUS REO¢iPIS <br />fHiS RECEIpIf <br /> <br />6U~IlTY <br /> <br />X~c(JUN f <br /> ~55.50 <br /> 36.73 <br /> <br /> $98.89 <br /> $O.O0 <br /> $98.89 <br /> <br />  BALANCE DUE $0.00 <br /> <br /> ,P,,A.,Y,~E: KORZ[N~KI, JUDIfH ~ \ 33809 <br /> <br />' IHIS IS NO, A PE~I'f. ~His APPLiCAT~ msim ~H~m A ~EVlE~ ~CE~ ~;~ THE- - <br />FOLLOWING ~Sr BE ~PLErED. l'r 15 THE R~$iBiLirY OF rHE APPLiC~'F rD ~Rg rHAr <br />ALL NECE~ARY INFO~]I~ H~ BEEN P~VIDED+ <br /> <br />CIIY JUrJSDlClI(,~4: BY BATE <br /> <br />3EPFIC: MY DAlE <br /> <br />FOS~ ~ MC ~,s~ ~Ev .~/~o OFFICE COPY <br /> <br /> <br />