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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO,, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 91301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE:: 588-1904 <br /> <br />Other_ <br /> <br />SIGNATURE OF APPLICANT <br /> <br />ow~¢"rE: 02/12/91 riMEs 15:08:28 <br /> <br /> NILLiAMSON, RO~ER'I <br /> <br />RESI DEN1 <br /> <br /> 19527 19537-19657-19681 C.,ASE RD NE <br /> AURORA OR 9?002 <br /> <br />U~E OF BUILDING <br /> <br /> CONTRACT CITY UCB <br />MARION E,'OI. JNt Y NO <br /> <br />OCCUPANI LOAD <br /> <br /> NO OF BEDROOMS <br /> <br />MAILIN0 ADDRESS SUBD~¥iSION <br /> <br />19527 CASE RD NE <br />AURORA <br />PHONE; 878-5588 SiTE NUMBER: 12138 <br /> VALUA r iON: <br /> <br />24 4S 2W EFU 9 <br />30. AC NO NO <br /> <br />TYPE: PLUMBING PE~i1 OR APPLICAIlON NO: 29917 <br /> <br />CONrRACfOR, NO. <br />~ILLIAMF:A2N, ROSERl <br />19527 CASE RD NE <br />AURORA <br />PHONE: 678-5588 <br /> <br /> ITEM <br />WATER LINE~, 1St 100 FEET <br />WATER LIN~, EA. AODL. 100 FEE1 <br />~iLE HOME SE1NER AND WATER CONNECflON <br />PLUMBING Si'ATE ~UIk-'CHARGE <br /> <br />PAYEE: <br /> <br />TOTAL A,%SIBE~EO FEE~ <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />(~XJANIlTY AI~,DUNI <br /> $20,00 <br /> <br /> 1 $25+00 <br /> $3.oo <br /> <br />63.00 <br /> <br />BALANCE D~JE $0.00 <br /> <br />RECEiPt NO: <br /> <br /> RECEIV£O BY: OL 1YPEt 6~ECK ~: 0 <br /> <br /> *THIS IS A VALID PEI;~IT * THIS PEJ:~IT E~olRI55 180 ~ ~ iTS I~E <br />~ST~CTI~ C~ ~A P~I~ 180 ~, ~ /E ~T~CTi~ FAI~ TO <br />R~iR~T~ OF STATE ~ ~D ~RI~ ~TY ~ILDJNG ~D Z~iN80RDIN~C~, THIS ~iT <br />~ALL 8~E NU~ ~D~ID. <br /> <br />REfC~RKS: I~H CON,<200F1' WL RAtA912 (19537) ~ <br />DONALD E. ~OODLE¥, i~tARJON C~UNTY BUILDING OFFICIAL / BY ..................................~ <br /> <br />FORM#MCI~-~SR£V 4/90 OFFICE COPY <br /> <br /> <br />