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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 />04/28/9'2 TIME: 8:59:06 <br /> <br />'bWNER: GREEN;JOE <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />DATE: <br /> <br />R~ID~NI'IAL <br /> <br />S~TUS X~dn~SS: <br /> AU~ <br /> <br />MAILING ADDRESS;' <br /> 20 HALKING WOOD DR <br /> LAKE r.3~-~NEGO, OR <br /> ~E~ 9?002 <br /> <br />OR 97002 <br /> <br />CONSTRUCTION TYPE <br /> <br /> OCCUPANCY <br /> <br /> JGB'. OCCURAN1 LOAD. <br /> NO <br /> <br />CENTURY IVlEAOONS NO 4 <br /> <br />SITE NUFE~ER: 92-01583 <br /> VAUJAT I ON: <br /> <br />LOT: 18 BLOCK 19 SECTION: 32 TOWNSHIP: <br />WIDTH' 65bERTH. 95 AREA {~1"/5. UNITS <br /> <br />RANGE 1~/~ ZONE: <br />RREG LOT: NO SORN~bNO <br /> <br />O~JN'I'RACTOR, NO. 73977 <br /> L/V iN OON 'rk JCTION <br />206 ~E 4TH <br />T~TDALE, 97060-0000 <br />~E: 760~'Z736 <br /> <br />NA'r~ L[N~, 1ST ~00 FEET <br />SE~ER LINES, 1ST 100 FEET <br />P~NG STATE <br /> <br />PAYEE: <br />RECEIVED BY: ~42 <br /> <br />TOTAL AE~ED FEES <br />PREVIOUS RECEiPT~ <br />THiS RECEIPT <br /> <br />0UANfITY At4OUNT <br />~ $20.00 <br />1 $30.00 <br /> $2.50 <br /> <br />~52.50 <br /> 52+50 <br /> $o.oo <br /> <br />' I ' BALN'~CE DUE $0.00 <br /> <br /> R,DCEiP'f' NO: <br />....................................... TYPE: CHECK <br /> <br /> ~ THIS IS A VALID PEI;~IT ~ THIS PERi, IT EXPIRI~S 180 DAY~ FR(~I iTS I~c~JE DATE. IF <br />~TRUCTI(~ ~.POR A PE~IODOF t90 OAYS. OR IF CONSTRtJCTIO~ FAiL~ TO ~E~T ALL <br />RE[~JIRE~TS OESTATEVoIDLA~.ANDiqARION COUNTY 8UILOING ANDZONING ORDINANCES, THIS PEI~IlT <br />~9~IALL 8EC~ENULLAND <br /> <br />R~R~: NL, SL <br /> <br />~ALD E. ~DLEY, MARI~ COUNI'Y BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15-58 REV. 4/90 <br /> <br /> <br />