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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SAL~E~M, OREGON 97301 <br /> <br /> PH ON E"588-5147 <br /> CODE-A-PHONE 4:30 F,M, - 8:00 A,M, <br /> <br /> I am performln!-j work on a property I own or occupy. <br /> lamaregistered builder OR( ) the authorized representative <br /> of a registered builder, <br /> Tho work will be performed by a registered builder. <br /> Other ....... <br /> <br /> DATE: 09/28/88 TIME: 11:59:218 <br />OWNER: MIX, FRANCIS A. <br /> <br /> 10955 MI)( RD <br />' AUMGVILLE OR 97325 <br /> <br />USE OF BUILDING: <br /> <br />:MAILING ADDRC_~Sl <br /> <br />: SAME <br /> <br /> PHONE: 749-1354. <br /> <br />LOT: :BLOCK; <br /> <br /> TAX LOT: :CATEGORY: RESIDENT, IAL <br /> <br /> CONSTRUCTION TYPE: ! OCCUPANCY: <br />SE ' <br /> MARION COUNTY <br /> <br />SUBDIVISION; <br /> <br />SITE NUMBER: 5515 <br />VALUATION: <br /> <br /> 05 9S 1W EFU 60 <br />:AREA: 20.0000 UNITS: AC : IRREG. LOT: NO <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR APPLICATION NO; 11191 <br /> <br />CONTRACTOR, NO_ <br />MIX~ FRANCIS A. <br />SAME <br /> <br />¢~HONE: 749-1354 <br /> <br /> ITEM <br />WATER LINES, 1ST 100 FEET <br />SEWER LINES, 1ST 100 FEET <br />MOBILE HOME SEWER AND WATER CONNECTION <br />FLEET SURCHA~E -ZONE 3 <br />PLUMBING STATE SURCHARGE <br /> <br />QUANTITY AMOUNT <br />I $20.00 <br />i $90.00 <br />1 <br /> $~.84 <br /> $3.75 <br /> <br /> TOTAL AS.SE~.SED FEES $82 _ 59 <br /> PREVIOUS RECEIPTS $82'. 59 <br /> THIS RECEIPT $0.00 <br /> BALANCE DUE:: $0.00 <br />PAYEE: ' <br /> RECEIPT NO: <br />RECEIVED EY: PB TYPE~': ~,:'¢J4ECK ~; <br />* THIS IS A VALID PERMIT TM THIS PEENIT EXPIRES 180 D~ ?FRC~vl iTTS I~x.~UE DATE. IF <br />CONSTRUOTION OEASB FOR A PERIOD OF 180 DAYS, OR IF'CONSTRUCTION FAYLS TO MEET ALL <br />REQUIREMENTS OF STATE LAINS AND MARION COUNTY 8UILD,INB AND ;rONIN6 ORDINANOB, THIS PERMIT <br />.SHALL B~E NULL AND VOID. .' . ~ <br /> <br />REMARKS: CONN WL $L R:~4879 '¢ <br />0ONALD E- WOOBLEY, MAR,TON COUNTY BUILDING GFFi:cIAL /:BY <br /> <br />I'ORM ~¢ Mp 15'5~J REV ~>/.7 OFFICE COPY <br /> <br /> <br />