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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 APPI, ICANT <br /> DATE <br /> <br />ow~'g: 12/13/90 111~4~: t3:04:23 <br /> <br />SITU~ ^PORE~EI~-NHAUS, DORIS <br /> <br /> 235 EVERGREEN OR <br />AtJl~Vl LI_E OR <br />USE OF BUILDING <br /> <br />AUMSVi LLE NO ,o o; <br /> <br /> P.O. ~OX 157 <br /> AUf~ViLLE, OR 9"f325 <br /> PHONE: '! ~ 9 - 152'? <br />tOT BLOCK <br /> <br />5i lE NUIV~ER: 'f 1928 <br />HAi~/~LUA7 ION'* ZONE MAP <br /> <br />fYPE: PLUP~ J. NG <br /> <br />P.bRMi¥ OR APPL]:O, AYiC'N NO: <br /> <br />CONTRACIOR, NO- 382~8 <br /> <br />113!3 ~ILLCREEK Rr'~ SE <br />,~UIWSVI LLE OR 9f325 <br /> <br />9029281 <br /> <br /> I f El~ <br />IVtOBILE HOt'4E S~-WfgR AND WAFER C~NNECFiON <br />FLEE! ~L;RCRARGk -ZONE 3 <br />PLUMBING ~IAfE SURCHARO~ <br /> <br />PAYEE: SAN! iA~ NO~iLE HOM~ <br /> <br />IOIAL ASSESSED FEES <br />PRE~dlOUS RECEIPTS <br />I'HtS RECEIPT <br /> <br />OUANT~TY AJt'lOUNI <br /> ~ $25,00 <br /> $3,84 <br /> <br /> $0.00 <br />$30.09 <br /> <br />BALANCE DUE $0.00 <br /> <br />iNVOICE NO: 30938 <br /> <br /> R~CDIVED BY: PR fYPE: IN CHECK ~: 0 <br /> * fHlb IS NOT A PER,liT. THIS AP~LiCAI'ION MUST C-O <br />FOLL~ING ~SI BE ~PLETED. iT i8 THE R~SIBiLiTY OF THE APPLICANT fO ~RE THAI <br />ALL NECE~RY iNPO~TI~ H~ BE~ <br /> <br />PLaN REVIEW: BY <br /> <br />RE~ARK$; W/S CONN <br /> <br />ClfY JUR[SDiC 1~: 8Y DAlE <br /> <br />OFFICE COPY <br /> <br /> <br />