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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 /> I am A rogistered builder OFf f I the authorizod ropresentatice SIGNATURE OF APPLICAN) <br /> of a re,qisterod builder, <br />L ) The work wdl be perfonnod bY a registered budder <br /> <br />(&&PF, ~.I EVE <br /> <br />rlME~ 9~41:57 <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />RESI DEN f J AL <br /> <br /> 7021' ~,HERI~N'4 RD <br />AUfVlfSV i LLE <br /> <br />CONTRACT CITY 5'U~B <br />MARION COUNTY NO <br /> <br />OCCUPANT LO~D-3 <br /> <br />MA LNG AODRF$$ ~iNGLE FAMILY DNELLiN~ <br /> <br /> PHONE: 749-2287 <br /> <br />LOT Ri CON SECTION <br /> <br /> VALUA r iON .* $14,630.00 <br /> TOWNSHIP RANGE ZONE MAP <br /> <br />29 UN~TS 8S IRREG LOT 1~ CORNER CPU <br />10 ~ AC NO NO <br /> <br />48 <br /> <br />TYPE: BUILDING <br /> <br />cc$1 rRAC ¥OR, NO. <br />GAPP, BREVE <br />SAME <br /> <br />PHONE; 749-228'! <br /> <br />PER~i'I OR APPLICAIiCN NO: 9032638 <br /> ARC,~ITECf/ENGINEER, NO. <br /> <br />BUiLDiNG FEE <br />PLAN RE'FlEW <br />BUiLDiNG ~[AIE ~URCHARGE <br />ZONING r~U RCHARGE <br /> <br />TOTAL .A,.,C~ESSED <br />PREWiOdS RECEIPr8 <br />THi~ RECEIPT <br /> <br />OUAN 1 11Y <br /> <br />A~Nf <br /> $110.50 <br /> $71.83 <br /> <br /> 5.5~ <br /> <br />$193.39 <br /> $o.oo <br />$199.~9 <br /> <br />BALANCE DUE <br /> <br /> PAYEE: GAPP, sf~VE~ , . s4~3~ <br /> RECEIVE~ BY: PR ~ ~YP~: CK [TrlECK ~: ~363 <br /> <br />* IHI~ 13 NOr A P~R~IIF. THIS APPLICATiON RuEr (1o [HRf,~JC-~H A RE¥1E~ PRL,Y.¢~ V,~-t~RE fHE <br />FOL, L~iNG ~S1 B8 C~PLE'f'gD. iT IS THE RES~SiBiLi1Y OF THE APPLIC~f 10 ~RB ~HAl <br />ALL NEC~RY iNFO~FION H~ BE~ P~VlOEO. <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 R~ 4/90 <br /> <br /> <br />