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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: 588-79O4 <br /> <br />( am performing work on 8 property I own or occupy. <br />lamaregistered builder OR( ) the authorized representative <br />of a registered builder. <br />The work wiJl be performed by a registered builder. <br />Other <br /> <br />have read and agree to the terms stated on the reverse side of <br /> <br />OWN~'f'E .* 05/22/'91 Ti'ME: <br /> CARI'Y, P~'I'RI CK <br /> <br />'¢z,v LOT. CATEGORY <br /> 90250-500 <br />CONSTRUCT DN TYPE OCCUPANCY <br /> <br />RESIOEN'I'IAL <br /> <br /> 305 LAKECRES'f' <br />DETROIT <br /> <br /> lO'TRACT CiTY <br /> <br />. -DELI'ROI'f <br /> <br />UGB <br /> <br />NO <br /> <br />PATTON [ <br /> <br /> 5631 ~ADE ST <br /> WEST LINN, OR 9?0§8 <br /> PHONE*. 858-4557 51IE NUfflSER: 12775 <br /> VALUA'F iON <br />~,OT' BLOCK. SECT ON TOWNSHIP. RANGE: ZONE <br /> <br /> ? 5 ..-21 lO 5E RS <br />WIDTH: DEPTH. AREA UNITS: I'R R E~. LOT CORNER <br /> <br /> 1 ]0 149 16390_ NO <br /> <br />TYPE: PLU~ lNG <br /> <br />CONT'RACT'OR, NO. <br />CAR'f'¥, PA'f'RtCK <br />5631C~AOE S'f <br />WEST LINN, OR 97068 <br />PHONE: 556-4557 <br /> <br />PER~iI' OR APPLICATION NO: <br /> <br /> iTEM <br />WATER LINGS, 18'T 100 FEET <br />I'¢fOSlLE HONE SENER AND WATER CONNECTION <br />PLUMBING S'fA'f'E SURCIHARGE <br /> <br />'31780 <br /> <br />1'OTAL,A,!~SES,SED FEES <br />THiS RECEIPT <br /> <br />fJUAN'I'i'I'Y AMOUNT <br />~ $20,0o <br />~ $25.oo <br /> <br />$47.25 <br />$47.25 <br /> $0.00 <br /> <br />BALANCE DUE $0.oo <br /> <br />PAYEE: iNVOiCE NO: <br />RECEJWk'D aY: CL TYPE: CHECK :~*. 0 <br /> <br /> ~ THiS 13 A VALZD PERIVIIT*~:::TH[s,PERMzT:EXpiRIDD180DAY~ FROM iTS t~E BTE. <br />~ST~CTi~ C~ FOR A,~R[OD OF ]80 ~. OR iD ~ST~CTZ~ FAI~ TO MEET ALL <br />~I~TS OF STATE ~ ~D ~RI~ ~NTY BUILDING ~O ~ING OROIN~C~, THIS <br /> L B~E NULL ~D ~ID. <br /> <br />REMARKS: WATER LINE & ~/S CONN <br />DONALD E. NCr-J'DLEY, MARION C(~NTY BUILDING OFFiCiAL /' BY ................................. ~ ....................................................... <br /> <br />OFFICE COPY <br /> <br /> <br />