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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 - 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />ow~'fE: 05/14/91 T~ME: <br /> W(.~OLSEY. DONALD <br /> <br />TYPE' <br /> <br />CATEGORYz <br /> <br />OCCUPANCY: <br /> <br />RESIDENTIAL <br /> <br /> 11226 BEAN ALLEY ROAD <br /> AUMSVILLE OR <br /> <br />US~ OF BUILDING <br /> <br />9?325 <br /> <br />SE <br /> <br />MARION COLIN'fY ' <br /> NO <br /> <br />OCCUPANT LOAD: <br /> <br /> NO OF 8EOROOM$ <br /> <br />MA{L{NG AODRES,~ <br /> <br />BU BDIVISION <br /> <br /> SAblE <br /> PHONE; 749-2444 <br />LO r. BLOCK S~CTION <br /> <br />WROTH' BEPTH AREA <br /> <br /> TOWNSHIP <br /> <br />18 9 <br /> J'NJTS: <br />1. AC <br /> <br />SiTE NUtflB ER .- 654 <br />VALUATiON: <br /> <br /> i EP'U <br /> NO : NO <br /> <br />MAP: <br /> <br /> 50 <br /> <br />TYPE: PLUfflB ~NG <br /> <br />PER, lIT OR APPLiCATiON NO: <br /> <br />coNrRAc'roR, NO. <br />WOOLSEY, EZ3NALD <br /> <br />PHONE: ?49-2444 <br /> <br />FrbBiLE HOC4E SEWER AND WATER CONNECTION <br />PLUFSiNG STATE ,~¢JRCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: CL <br /> <br />31839 <br /> <br />TOTAL AC.%~ESSED FEEt5 <br />BALANCE DUE <br /> <br />qu~ T i 'fY <br /> 1 <br /> <br />At4OUNT <br /> $25.00 <br /> $1.25 <br /> <br /> ~25.25 <br /> ~47.25 <br /> -$21.00 <br /> <br /> $0.00 <br /> <br /> RECEIPT NO: 33991 <br />TYPE: CHECK ~: 0 <br /> <br /> :~ THIS IS A VALID PE~/T *: THiS PI~R~41T ~XPIRE~ 180 [)AY'5 FRO~ IT,~ I,S~UE DATE. iF <br />C(~STRUCTION CEASES FOR A PERIOD OF 180 DAY~, ORII: CONSTRUCTION FAILS TO rflEET ALL <br />~J~JiRiEflE~T$ OF STATE LAW~ AND f4AR'ION COUNTY BU/:LDIN~ AND ZONING ORDINANCE,'5, THiS PER,lIT <br /> ALL BECOME NULL AND <br /> <br />REMARKS: BONN R;r~7521 REFUND BA~E FEES21 <br /> <br />DONALD E. WOODLEY, MARION COUNTY BUiLDiNG OFFICIAL / BY <br /> <br />OFFtCECOPY <br /> <br /> <br />