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MARION COUNTY BUILDING INSPECTION <br />SENATOR 8LPG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-S147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I 8m performing work on 8 property I own or occupy. <br />lamaregistered builder OR( )theauthorizedrepresefltatlve <br />(Df a registered builder, <br />The work will be performed by a registered builder. <br />Other_ <br />I have read 8nd agree to the terms stated on the reverse side of <br />this document <br /> <br />OWNEn:DATE: 01/13/93 TIME: 10:24:11 <br /> <br /> BURLEIBH, JAMES & LECTA <br />SlIf US ADDgESS: <br /> <br />, TAX LOt; <br /> <br /> 56510946 <br /> dGN~Rg~TION YYPE; <br /> <br />CATEGORY: <br /> <br /> RESIDENTIAL <br />OCCUPANCY: <br /> <br /> 11982 STEINKAMP RD SE ' CONTRACT CIT~: , OGBi OCCUPANI LOAD: <br /> <br /> AUMSVILLE OR 97325 'MARION COUNTY; NO <br /> <br />MAILING ADDgESS; ~UBE~IVi~ON; <br /> <br />PO BOX 18102 <br />SALEM 97305 <br />PHONE: 393-8790 <br /> <br />SITE NUMBER: 93-00150 <br />VALUATION: <br /> <br />WIDYH: DEPTH: AREA: UNITS: <br /> 1.666 AC NO NO <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR APPLICATION NO: 44621 <br /> <br />CONTRACTOR. NO. <br />BURLEIGH, JAMES & LECTA <br />PO BOX 18102 <br />SAtEM 97305 <br />PHONE: 393-8790 <br /> <br /> ITEM <br />WATER LINES, iST 100 FEET <br />PLUMBING STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br /> 1 $2O.00 <br /> $1.00 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIB RECEIPT <br /> <br />$21.00 <br />$21.00 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: PM .................................... TYPE: CHECK ~: 0 <br /> <br />* THIS IS A VALID PERMIT * THIS PERMIT EXPIRES 180 DAYS FROM ITS ISSUE OATE. iF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR iF CONSTRUCTION FAILS TO MEET ALL <br />EQUIREMENTS OF STATE LAMS AND MAR[ON COUNTY BUILDING AND ZONING ORDINANCES, THIS PERMIT <br />SALL BECOME NULL AND VOID. <br /> <br />REMARKS: WATER LINE - WELL TO MH ~ ~ <br />DONALD E. WOODLEY, MARION COUNTY BUILDING OFEICIAL / BY ........................................ ~_ <br /> <br />FORM # MD 15-56 REV, 4/90 OFFICE COPY <br /> <br /> <br />