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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:$0 <br />24 HOUR CODE-A-PHONE: ~88-7904 <br /> <br />Other <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />r l ~-I b R, ?qA f T lq ~W <br /> <br />5'Z'?U6-000 <br /> <br />}25 ~P¢,~UCb_ f~r <br /> <br />OR 9'f325 <br /> <br />2~I OONTRACT CITY <br /> <br /> AUMSV i LL~ <br /> <br />UGB <br /> <br />N© <br /> <br />OCCMPANT LOAD <br /> <br /> NO 0P BED~00M~ <br /> <br /> PO BOX '12736 <br /> <br /> Pk'iONb; 2.~'/--590'f Si YE NUIVlI.~ER: ]3263 <br /> VALUA I iON:: <br />i OT BLOCK SECTION TOWNSHIP RANGE : ZONE MAP <br /> <br />YYPb." t>l. (II~I,~'~fNG PERMi f OR A¢gPLiCAf ION NO: <br /> <br /> J I LP" <br /> <br />PLUPb~ilx ::51A T/:,_, SURCH ARGb <br /> <br />THiS R~E~PT <br /> <br />QU,~NIIIY AI~()UNT <br /> <br />$26 25 <br />$2~.25 <br /> $0 <br /> <br />~ALANCE OUE $] 0(; <br /> <br /> .b ff1v::.9 i~Y: CL ........................................................... IYPE; CH~CK ~: O <br /> <br />* TNiS iS A VALID P~RMIT * THiS PEF$,IlT ~XPiRES 180 DAYS FROM ITS I,SSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 BAYS, OR iF CONSTRUCTION FALLS TO REET ALL <br />RE(JUIREM~NT$ OF STA"rg LAN~AND MARION COUNTY BUiLDiNG AND ZONING ORDINANCES. THiS PEr, liT <br />SHALL ~ECOME NULL AND ¥O1D. <br /> <br />REMARKo CONN ~ <br />IjDN~LD E_ :~OODL£Y, ~4AIRZON COUNTY 8Ui~DIN(~ OFFICI:L / 8¥ ................ <br /> <br />FORM # MC 15,56 REV 4/~¢0 OFFICE COPY <br /> <br /> <br />