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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 />DALE: 01/28/91 ~IME: 11;78;42 <br /> WILSON, JOHN <br /> <br />SIfuS ADDRESS <br /> <br /> 9292 ~IfH RO SE <br />AUMbVI LLE OR 97925 <br /> <br /> 983 <br />AUfckSVILLE, OR <br />PHONEz 3?9-4569 <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br /> CONTRACT CITY <br />NARI ON C%)UN1Y <br /> <br />LOT BLOCK SEC f ION TOWNSH I¢ <br /> 51 <br /> <br />644-0 <br /> <br /> SiTE NUMBER; <br /> VALUATION: <br /> <br /> RANGE <br />8S 2W <br /> <br />AC IHREG LOT NO <br /> <br /> 12059 <br /> <br />ZONE <br /> <br />CO~N~ho <br /> <br />CATEGORY R~i DENI IAL <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br /> 3 <br /> <br />MAP <br /> <br />fYPE.· F1081LE HOf, IE <br /> <br />CONTRACTOR, NO. <br />WILSON, JOHN <br />P.O. 983 <br />AUMSVILLE, OR <br />PHONE: 370-4569 <br /> <br />PERt411 OR APPLICATION NOs <br /> <br />I1EM <br />1~281LE HOME B~E FEE <br />r4OBiLE HOME SLATE FEE <br />MOBILE HOME ZONING ~URCHARGE <br />f~IOBiLE HOME SLATE SURCHARGE <br /> <br />PAYEE: <br /> <br />29690 <br /> <br />TOrAL ASSESSED FEES <br />PRE¥i~JS RECEIPTS <br />THIS RECEIPt <br /> <br />QUANIIfY <br /> <br />Att~JUNI <br /> $89.25 <br /> <br /> ~5.25 <br /> 5-25 <br /> <br />~115.50 <br />116_50 <br /> $o.oo <br /> <br />BALANCE DUE $0-00 <br /> <br />RECEiPf <br /> <br /> RECEIVED BY: CL TYPE: CHECK ~; 0 <br /> <br />* THiS IS A VALID PERD'IIT :d,: THi.5 PERMIT EXPIRES 180 IDAY~ FROM iTS iS.S,UE DATE. iF <br />CONSTRUCTION CFr./~ES FOR A PERIOD OF 180 DAYS,OR iF CONSTRUCTION FAILS TO MEET ALL <br />REQUIRE~TS OF ,STATE L.NA~ AND MARION COUNTY BUILDING ANO ZONING ORDINANCES, THiS PERMIT <br />SHALL B~E NULL AND VOID. <br /> <br />5E1BACKS: FR 20 L5 40 RS 10 RR 30 SP ..... <br />RENARF~: ~ ¢'LACE3~IF~'I R~4853 -' <br /> <br />PLANNING ACIlON: CU 90-97 <br />g~ONALD E_ ~OODLEY, MARION Cf. XJNIY BUILDING OFFiCiAL / BY <br /> <br />~ORM # MC 15.56 REV 4/90 OFFICE COPY <br /> <br /> <br />