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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 />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />03/06/91 f IM~-: 9:05:10 <br /> <br />ELO~E~, KYLE. &OANA <br /> <br />'CATEGORY <br /> <br />DEN ] IAL <br /> <br /> 225 ,b. VREGREEN OR <br />AUF4UVI LLE OR 9'F~25 <br /> <br /> CONTRACT CITY <br /> <br />AUf4SV[L LE <br /> <br />UGB <br /> <br />NO <br /> <br />11373 MiLL CREEK RD <br />~U~VILL~, OR <br />PHONE; <br /> <br />55 I 14 6270. <br /> <br />EVERGREEN ~5¥A]~5 ~H ~ARK <br /> <br />SiTE NUMBER: 12425 <br />YALUAfION; <br /> <br />RANGE ZONE <br /> NO NO <br /> <br />fYPE: PLUMBING PgRMIf OR APPLICAfiON NOt 30732 <br /> <br />CONfRACfOR, NO_ 38238 <br />SANItAM NC~iL~ ~tOME5 <br /> <br />AU~SViLLE OR 97325 <br />PHON~: Z69--7744 <br /> <br /> iTEM <br />MOt~iLE HOt4E SEWER AND WAFER CONNECflON <br />PL.Uf',~ING 5]ALE 5UKCHAR"GE <br /> <br />fO'FAL ASSESSED FEES <br />PReViOUS R~EIP~S <br />fHiS RECEiPt <br /> <br />~UANfI~Y AMOUNT <br /> I $25.00 <br /> $1.25 <br /> <br />$26.2b <br />$28.25 <br /> $0.00 <br /> <br />BALANCE OU~ SO,OD <br /> <br />PAYEE: iNVOICE NO; <br />RbCblVED k~Y¢ CL2 ~YPE: C~CK ~: 0 <br /> <br /> THiS IS A VALID PERMIT · THIS PERf4iT EXPIRE~ 180 DAYS ?ROM iTS iSSUE ¢ATE. IF <br />CONSTRUCTION CEA.SES FOR A PERIOD OF 180 DAYS. OR 1R C~NSTRUCT1ON FALLS TO MEET ALL <br />RE(~UiREM~NTS OF STATE LAWS AND MARION COUNTY BUZLDING AND ZONING ORDiNANCI~S, THIS PERMIT <br />~HALL BECOME NULL AND VOID. <br /> <br />REMARKS; MH CONN <br /> <br />I,)ONALD g. WOOBL~Y, ~ARION Cw, iJN1Y BUILDING OFFICIAL / BY <br /> <br />FORM # MC 1~-5~ Rb~/ 4/S~ OFFICE COPY <br /> <br /> <br />