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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />Other__ <br /> <br /> PHONE:588-514? 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> S,~N^Tu.B Or <br /> <br />; OWNER: DATE: lo/i6/9 <br /> RONALD <br /> <br />TIHE: 12 =.56:i9 .... f~X'[Cf: CATEGORY: <br /> 56113;000 RESIDENTIAL <br /> : CONSTRUCTION TYPE'. i OCCUPANCY: <br /> <br /> 9844 KEENE LN SE id~ OCCUPANT LOAD: <br />AUHSVILLE OR 973;25 :NARION COUNTY i HO <br /> : NO OF BEDROOMS <br /> <br />580 <br /> <br />SAME <br /> SITE NUMBER: '92-05697 <br />PItONE: 749~1018 VALUATION: <br /> <br />TYPE: PLUMBING <br /> <br />CONTRACTOR, NO. <br />HORRISON~ RONALD <br /> <br />PHONE: 749-$0i8 <br /> <br /> ITEM <br />WATER LINES, 1ST icc FEET <br />SEWER LINES. 1$~ 100 FEET <br />PLUMBINQ STATE oURCHAR~E <br /> <br />PAYEE: NORRISON, RONALD <br /> <br />PERMIT OR APPLICATION NCI: 9045268 <br /> <br /> TOTAL ASSESSED FEES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br />8AL:ANQE DUE <br /> <br />QUANTITY AMOUNT <br />i $20.00 <br />1 <br /> $2.50 <br /> <br />$52.50 <br /> $0.00 <br />$$2.50 <br /> <br />$0.00 <br /> <br />RECEIPT NO: 45349 <br /> <br />RECEIVED BY: gL ................................ 1_.. TYPE: CA CHECK ~: O <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. iT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSARY INFORMATION MAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY ........... DATE .............. <br />REMARKS: < ZOO FT WL. SL <br /> <br />CITY JURISDICTION: BY ............ DAlE ..................... <br /> <br /> OFFICE COPY <br />FORM # MC ~ 5-56 REV, 4/9o <br /> <br /> <br />