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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 />01/30/91 liME: <br /> <br />GIBNGBR, 0ONALD A. <br /> <br />14:15:57 <br /> <br />R(~$ i DEN f 1 AL <br /> <br />11683 'f'HRU~H <br />AU k~RA <br />USE OF BUILDING <br /> <br />OR 97002 <br /> <br />NE <br /> <br />2 ~ CONYRAD'T CITY UGB <br /> MARION COUN l Y NO <br /> <br />DEN4 URY I"'4E A ~ <br /> <br /> 10915 ~ HALL BLVD ~2 <br /> flGARD, ORE 97223 <br /> PHONE: 684--6142 SiTE NU~ER: 12187 <br /> VALUA71 ON: <br />LOT RI OC, K SECTION TOWNSHIP RANGE ZONE MAP <br /> <br />21 ~.~, <br /> 65 85 5525. <br /> <br />~J'~' IRREG LOT lW CORNER <br />~P NO NO <br /> <br />IYPE: PLUIVl81NG <br /> <br />PER'if OR APPLICATION NO: 9030086 <br /> <br />CON'1RACIOR, NO. <br />GiENGER, L¥3NALD A. <br />10915 ~ HALL IBLVD ~2 <br />fiGARO, ORE 97223 <br />~E: 684~6142 <br /> <br />WAFER LIN~, 15f 100 FEE[ <br />5~WER LINES, 151 100 PEEl <br />HOSILE HOME 5gWER AND WATER CONNECTION <br />PLUIV~iNG $1A1g 5URCHANYciE <br /> <br />QUAN]iIY AMOUNI <br /> 1 $20.00 <br /> <br /> $3.75 <br /> <br />FOTAL~ED FEES <br />PRE¥iOUS RECE[P1S <br />THiS RECEIPT <br /> <br />$?8.75 <br /> $o_oo <br />$?8. ?5 <br /> <br /> ~:~,,,~.LANCE BUg <br /> PAYEb; GIbNGER, DONALD A. ~"%\ RECEIPf NO; 31791 <br /> RgCEIVED BY: 0~2 ~ ~ ~YPE: CK CHECK ~: 3?5 <br /> <br />· THIS 18 NOT A PER~IT. THIS APPLICATION FIUST 60 TH~ A R~I~ P~ ~ERE THE <br />~DLL~ING ~S'f BE ~PLETEO. iT IS THE ~SiBILITY OF THE APPLI~T TO ~RE THAT <br />ALL NEC~ iNFO~Ti~ H~BE~ P~V~DEB~ <br /> <br />PLAN REVIEW: BY DAlE <br />R~RKS: WL/SL/CONN R~5799 <br /> <br />CiTY JURiSDiCTiON: BY <br /> <br />OAf6 <br /> <br />FOR~ ~ MC ~,~-,~e Rev .~/~o OFFICE COPY <br /> <br /> <br />