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MAHION CC)UN I Y 15UILL)IN~, IN~I-'P_..L; I IUN <br /> SENATORBLDG NO. 225 <br /> 220 HIGH STREI::T <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 Fegistered builder OR the authorized represen ave S GNATtjRE OF ARRL CANT _.~'~ <br /> <br />~WNI[;)~FE: 09/18/91 FINE: 11 ."09'.16- TAX LOT '' I'C~,¥E6ORY '1 <br /> FR~EN, JOE OONSTRUCT ON TYPE ~_,.,.~ R~IOBN1 IAI <br /> <br /> 11697 FAL~ <br /> <br />ADDRESS <br /> <br />......... C EN.T U F~Y....EtEA L.¥.:~ ~ <br /> <br />t OT ~ BLOCK SECTION ' fOWNS~4 p <br />W~DTH 32 DEPTH ~ 9 ' AREA UNITS <br /> 6f~ 125 <br /> <br />SiTE NUt'lB ER: 14128 <br />V~.~U.__A_.l~ i g~N.: ........ <br />~ANGE ZONE MAP <br /> <br />~R~EG k~' CO~E~ ....... <br /> Y~ NO <br /> <br /> fYPE: PLUMBING <br /> <br />~ I RA~7.1 OR, NO. <br />GREEN, JOE <br /> <br />PERMiF OR APPLICA'FION NO: <br /> <br />35231 <br /> <br />I[EN f.,)tJ,~fiTY AMOUNT <br />WATER LiNE~. 1S'F 100 FEEF 1 $20.00 <br />SEWER LINES, 1S1 100 FEEl I $30.00 <br />PLUMBING STAFE SURCHARGE $2.50 <br /> <br />PAYEE: GREEN, JOE <br />RECEIVED BY: [2~12 <br /> <br />TOTALA'S~ED"FEES $52.50 <br />PREVIOUS REX;E~PT'8 $0.00 <br />THiS RECEIPT $52.50 <br /> <br />8~LANCE C~JE $0.00 <br /> <br /> RECEiP¥ NO: 37131 <br /> TYPE$ CK CHECK ~: 281 <br /> <br />FORM # MC 15-56 REV 4~90 OFFICE COPY <br /> <br /> <br />