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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-?904 <br /> <br />I am performin9 work on a property I own o¢ occupy <br /> <br /> (]5/29/91 f IME: <br /> <br />cf-O~ ES, G~ORGE <br /> <br />TAX LOT <br /> <br />CONSTRUCTION fYPE <br /> <br />C~TFGORY <br /> <br />OCCUP&NC¥ <br /> <br /> 245 EVERGREEN DN <br />AL.IMSV 1 LLE <br /> <br />OR 97325 <br /> <br />] 400NTRACT CITY <br /> <br /> AU~Vi LLE <br /> <br />UGB <br /> <br />NO <br /> <br /> P.O. 8OX 636 <br /> &UN~ViLLE, OR 9/325 <br /> PHONE: 749-2792 <br /> <br />LOT BLOCK SECTION TOWNSIIIP <br /> <br />~llE NUIV~; 1J057 <br /> <br />MAP <br /> <br />55 '1 14 6270. <br /> <br />SF NO NO <br /> <br />iYPE: PLU~8£NG PER~I~ OR APPLICAflON NO: 32435 <br /> <br />(;ONIRACfOR, NU. 14922 <br />CEN f RAL OREGON <br /> ~O_PAC [F LC H iGHI~Ay <br />~,¢0ODBUFSN, OREGON 9'/071 <br /> 981-3141 <br /> <br /> ifEM <br />IV'OBILE H(i,Wlg 5EWER AND RARER CONNECTION <br />CLUMBJNG DfATE SURCHARGE <br /> <br />TOTAL A.SS~D FEE5 <br />PREVIOUS RECEIPTS <br />FHiS RECEiPF <br /> <br />QUANIIIY AMOUNT <br /> 1 $25-0O <br /> $~,~5 <br /> <br />~26.25 <br /> 26,25 <br /> $0.09 <br /> <br />BALANCE DUE $0_O0 <br /> <br />iNVOiCE NO: <br /> <br /> ~qf:CEIVED ~Y; CL. . ............................................ TYPE: CHECK ~: <br /> <br />*;, THiS IS A VALID PER~IT * THIS PBR~iT i~KPiR~.¢..S, 180 DA'f~ Fi;U;)(~I ITS I~ ~TE. iF <br />~ST~C'[l~ O~ FOR A PERIOD O~ ]80 ~YS. OR IF ~ST~OTI~ FAi~ TO MEE~ ALL <br />RE~IR~T5 OF STATE ~ ~O ~RI~ ~N~ BUILDING ~D Z~ING ORD~N~C~, THIS Pg~IT <br />~ALL B~E NULL ~O VOID. <br /> <br />i4EM,ARKS: i~H CONN <br /> <br />D%)N4LD ~. WOODLgY, MARION COUN1Y BUILDING OFFiCiAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />