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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Chumh 8trot NE · Room 182 · 8~lem, O~gon 97~01-~670 <br />Offloe Hour~: 8:00-4:~0 · Phone: (503) 588-5147 · 24-HR Inlpeotion Lin®: (503) <br /> <br />DATE/TIHE <br />TYPE <br />OCCLIPN, ICY <br /> <br /> PLUHBING PERHIT <br />~/23/96 14:46 PERHIT HO : 96-03663 <br />Resident. addition/aZteration STATUS : ISSUED <br />R-3 ISSUED : 05/23/1996 <br /> TO EXPZRE = 11/19/1796 <br /> <br />WORK DESC : 1 LAWN SPRINKL. ER/BACKFLOW DEVICE <br /> <br />SITE ADORESS : <br /> 715 MICHAEL WY AM <br /> <br />CROSS STREET : 4TH ST TO MICHAEL WAY (NORTH OF STREET) <br /> <br />PARCEL NtlHRER : 57816-909 <br /> <br />OWNER NAMF <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br />PHONE <br /> <br />Pl..UMBER <br /> PHONE' <br /> <br />: HERN,KEVIN F & TERRI L <br /> <br />CITY: AUMSVILLE <br /> <br />PROPERTY LOCATOR: 882W25AB00280 <br /> ZONE: <br /> <br /> : HERN.KEVIN F & TERRI L <br /> : PO BOX 925 <br /> AUMSVILLE, OR <br /> ?7525 <br /> : 747-1515 <br /> <br />CONTRACTOR : HERN, KEVIN F & TERRI L OCCB: <br /> PHONE : <br /> <br /> : <br /> : LICENSE: <br /> <br /> Unit~s Description Fee <br /> · PlUmbing base fe~ ~.-~ <br /> I Lawn vacuum breakers 4.50 <br /> ]. State surcharge 1.2~ <br /> 1 Refund .00 <br /> <br /> Assessed fees : 25.73 <br /> Adjustments : .00 <br /> Total fees : 25.75 <br />PAYEE: HERN, KEVIN F & TERRI L TotaI paxMents: 25.73 <br /> Balance due : .00 <br /> <br />THIS PERHIT IS HOH-TRNqSFEI~BLE AND EXPIRES 18~ ]N~YS FROH ISSUE IN~TE IF ~ORK HAS <br />NOT COHHENCED, OR IF CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS. OR IF #ORK <br />FAILS TO HE:ET ALL REGUZREHENTS OF STATE LAtJ~AND HARION COUNTY ORDIHAHCES. UPOH <br />#RITTEN REQUEST~ ONE SIX (&) HONTH EXTENSION HAY BE GRANTED. <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />DONALD E WOODLEY, MARION COUNTY BUILDING OFFICIAl. / BY LIDAVIS <br /> <br /> <br />