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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 />DAIP,,., 01/U6/92 ~IN~[:: t4:23:]4 <br /> <br /> ~:iLAN, DAN ~ <br /> <br /> 120 ~PRUC~',! <br />~:k(J fvl~v ~. I,. L P.. OR 9';325 <br /> <br />SIGNATURE OF APPLICANT <br /> <br />DATE <br /> <br /> TAX LOT <br /> 5"fV06-OOU <br /> <br />AU~VlSV,][ LLg . .NO <br /> <br />CATEGORY <br /> <br /> 51NGL~ pAIVt[LY OWELLING~'~ <br />MAILING ADDRESS SUBdIvISION <br /> <br />fYP,~; rVlAMJI"ACI'UR~D ,"STR"UCfU~ R~Rr4tf OR APRLICAflON N(.): 3'?~'18 <br /> <br />PHONE: <br /> <br />TO'tAL. ASSESSED F~E5 <br />PREVIOUS RECP2I P T'5 <br />I t"t i S RE.P.. f.P 1 <br /> <br />$~82.oo <br />$20.00 <br /> <br />$21~_~ <br /> <br />DUE $0_ 00 <br /> <br />~L~AING, ~TAIR iN~TAL~T[~. P~ING, ~E~ICAL, ~ EL.ECTRiCAL ~NECII~S ARE RE~IREO i( <br />BE ~PLETED U~ RE~T FOR THE FI~T IN~PECTI~. IF ~Y OF THE iT~ ARE IN~PL~, ~ <br />,A~OITI~AL iNSPECTI~ FEE ~ILL ~E RE~IRE~. PE~iT [~ VALI~ FOR ~IX ~TH~ ~LY. R~EO FOR <br />6 ~THS U~ NRITT~ RE~T FOR ~ ~T~S[~, PRIOR TO THE ~PI~TI~ ~ATE OF TH~ RE,lT. <br />IE ~S"f'~CTI~ EAi~ TO ~[ET AbL RE~iR~T~ OF ~TATE ~ ~D ~RI~ ~NTY BUigDING ~D <br />Z~iNG ORDiN~C~, THi~ PE~iT ~ALL BEdE NULE ~D VOID. <br /> <br />Sgf~CKS FR 1~ L5 !5 R~ 15 RR 15 ~P <br /> <br />PLANNJNC ACTION: <br />DON~LL) E, NOQDLEY, ~AR[~N COUNTY ~U[LDING OFFiCiAL / ~Y <br /> <br />OFFICECOPY <br /> <br /> <br />