Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-514'7 8:00 - 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />l am a registered builder OR { ) the authorized representative <br />ct a registered builder, <br />The work will be pedormed by a registered builder. <br />Other <br /> <br />I have read and agree to the terms stated on the reverse side of <br />this document, <br /> <br />bWN~ATE: 05/56/92 <br /> <br /> Cif'Y OF AUIv~SVILLE <br />SITUS ADDRESS: <br /> <br /> 125 6TH <br /> ADC4~ViLLE <br />use o~ 80~LdiN~i <br /> <br />OR 9?325 <br /> <br /> 90080-510 <br /> <br />,NJME, V.~, L,L,E .... NO -. <br /> <br />C(2ffll~bl'~g; I AL <br /> <br />MAILING ADDRESS; <br /> <br />~UBLIC ~ORK~ AND U'rlLiTIE~ T~UiLDi~wsl0N <br /> <br />Fl3 BOX 227 <br />AUMSViLLE OR 97325 <br />PHONE: ?49-2030 <br /> <br />?/8 11 25 .... 83 <br /> 75 108 8100. ~F <br /> <br />MERREFiELD~ ADDN <br /> <br />SiTE NUIV~3ER~ 92--01984 <br /> VALUA'rlONz <br /> <br /> NO YES <br /> <br />TYPE: BUILDING PERi, IT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 51352 <br /> Rea Cc~stnuctior~ ln¢ <br />PO Box 617 <br />Stayton, 97383-0000 <br />PHONE: '/69-6568 <br /> <br />BUILDING FEE <br />PLAN <br />BUILDING ~'I'A'I'E ,.~4JRCHARr-SE <br /> <br /> 9040198 <br />AR(.~ITECT/ENGiNEER, NO. <br /> <br />PHONE: <br /> <br />TOTALA,!~ED FEES <br />PRE¥iCU$ RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />$38.50 <br />$25.03 <br />$1+93 <br /> <br />$65.48 <br /> $o.o0 <br />$65.46 <br /> <br />BALANCE BIDE $0.00 <br /> <br /> PAYEE: Rea Cc~structlo3 inc n~ , 42243 <br /> RECEIVED BY: TH ~ TYPE- IN C~ECK ~- 0 <br /> <br /> * THiS iS NOT A PERIvlIT. TH[8 APPLiCATiON h/dST GO THRCXJE~H A REVIEW PROCE~ NHERE ;'HE <br />FOLLOWING f,1,J~'f BE Cf,~PLETED. iT I$ THE RESPONSiBiLiTY OF THE APPLICANT TO ~RE THAT <br /> <br />ALL NEC~ARY I NFORNA~ON HAS BEEN PROVIDED. <br /> <br /> SEPTIC: BY ........................................... DATE <br /> <br /> ZONING: BY DATE ~EI'BACKS; FR.._/ ~_../ <br /> R~R~: ~BE'-~F FOR <br /> <br /> E.[GHf :.~ TOTAL ~ <br /> <br />CiTY JURISDICTION: BY <br />ENERGY PATH: <br /> <br /> RS..../ RR.,,./ $P ................... <br /> <br />DATE <br /> <br />PLAN.ACTiON: <br /> <br /> OFFICE COPY <br />FORM # MC 15.56 REV. 4/90 <br /> <br /> <br />