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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 />am pe~formmg work on 8 property I own or occupy <br />I am a reglstOred budder OR Ii ) the authorized reptesentaDvo BIONATURE OF APPLICANT <br />of a registered buddor <br />Th8 work will be performed by ,~ registered buildor <br />Other <br /> <br /> 19527 19537 CAS~. RD NE <br />AURORA OR 97002 <br /> <br />USE OF BUILDING <br /> <br />MAILING ADDRESS <br /> <br /> 19527 CASE RD Nc" <br /> AURORA <br /> PHONP_: 6?8-5588 <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br />CONTRACT CITY UGB <br />f4AR,~ ON CO~JN1Y NO <br /> <br /> SUBDIVISION <br /> <br /> Bile NUIN18ER: <br /> VALUAT iON: <br /> <br /> CATEGORY <br /> OCCUPANCY <br /> OCCUPANT LOAD <br /> <br /> NO OF 9ED~O0~S <br /> <br />121,38 <br /> <br />LOT BLOCK SECTION <br />WIDTH DEPTH AREA <br /> <br /> TOWNSHIp RANGE ZONb <br />24 4S 2N <br /> <br />30. UNITS AC IRREG LOT NO CORNE~ <br /> <br /> MAP <br />EFU 9 <br /> <br />)YPE: PL0'~"iN6 <br /> <br />C'ONrRACFOR, NO, <br />WlLLIAMSON, ROEIERT <br />19527 C.~N,~E RD NE <br />AURORA <br />PHON~: 678~5588 <br /> <br />PERMII OR APPLiCA1]ON NO: <br /> <br /> iIEM <br />NA'rER LINES, lsr lOO F'EEF <br />WAIER LIN~, ?A. ADDL, 100 FEE') . <br /> <br />PLUIFF~iN6 SLATE ~Rf~IIAROE <br /> <br />PAYEE$ WILLiA.r4SON, <br /> <br />902991? <br /> <br />tOTAL A~EE~ED FEES <br />PRE¥iOU$ RECEIPTS <br /> RECEIPT <br /> <br />r~AN'fIIY AI~'FOLIN! <br /> <br /> 1 $15.00 <br /> $25.00 <br /> $3.00 <br /> <br />$53.00 <br /> $o.oo <br />$63.00 <br /> <br />BALANCE £]JE $0.00 <br /> <br />RECEIP[ NO: 31621 <br /> <br /> RECEIVED BY: CL TYPE-~ CK CHECK ~t: 1689 <br /> <br /> THIS 18 NOT A PEI~IIT. THiS APPLICATION MU~T GO ~ A R~I~ P~ ~ERE THE <br />FOLDING ~ST BE ~PLETED. iT I~ THE R~SISILiTY OF THE APPLIC~T TO ~RE THAT <br />~L N~ IN~TI~ H~ BE~ P~IDED. <br /> <br />PLAN REVJ:E~: BY ................ DAlE .......................... <br />REf'.IARF, E,: D'H CON,<200EF NL R~4912 (19537) <br /> <br />CllY JURISDICIlON: BY DATE <br /> <br />FORM # MC 15-56 REV 4/90 OFFICE COPY <br /> <br /> <br />