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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: 538-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performlflg work on 8, property I own of' occupy. <br /> <br />°f 5 registered builder" a ¢¢g,stered buildeR, <br />The work will be performed by <br /> <br />OWNER; DATE; 09/08/9;3 TINE.: 12.11]~:04 fA~ Lot; <br /> MCLAUGHLAN.j ROBERT <br /> <br />RESIDENTIAL <br /> <br /> 10&79 STAYTON RI) SE ; CONTRACT CITY: UGB~ !OCCUPANT <br /> AUMSVILLE OR 97325 , MARION COUNTY NO <br /> <br />MA~LING ADDRESS: SUBDIVISION: <br /> <br />SANE <br /> SITE NUMBER: 73-824~8 <br />PNONE: 769-,~124 VALUATION: <br /> <br /> ~ ; ~,,!~,,' 66 ~0 ;.,Nfl <br /> <br />TYPE: PLUMBING <br /> <br />OONTRACTOR~ NO. <br />M~LAU6HLAN, ROBERT <br />SAME <br /> <br />PHONE: 769-~124 <br /> <br /> ITEM <br />WATER I..INES~ 1ST i00 FEET <br />WATER LINES, EA. AgI)L. 100 FEET <br />SEWER LINE$~ 1ST 100'FEET <br />PLUMBING STATE SURCHARGE <br /> <br />PAYEE: HCLAUGHLAN~ ROBERT <br /> <br />PERMIT OR APPLICATION <br /> <br />TOTAL ASSE$SE~ FEES <br />PREVIOUS RECEIPT~ <br />:THIS RECEIPT <br /> <br /> BALANCE ~UE <br /> <br />QUANTITY AMOUNT <br />1 $20,00 <br />1 $15.08 <br />1 $30.00 <br /> $3.25 <br /> <br />$68.25 <br /> <br />$0.00 <br /> <br />RECEIPT NO: 52081 <br /> <br /> RECEIVED BY: c12 : :; ::: :; :: : : TYPE: CK CHECK $.~ 13;]1 <br /> $ THIS IS NOT A PERMIT, THiS APPLICATION HUST ~ THROUGH A REVIEW PROCESS WHERE THE <br />FULLOWiNG MUST ~E COMPLETED. IT ZSTHE RESPONS~B[LzTY 8FTHE APPLICANT TO ASSURE THaT <br /> <br />PLAN REVIEW., BY 1)ATE ..... ~___ : CITY JIJRISI)ICTION: BY DATE <br />REMARKS: WL,~gL <br /> <br />OFFICE COPY <br /> <br /> <br />