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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Houre: 8:00-4:30 * Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br /> AUll'IORIZAT~ON/I~AJOR REPAIR PERItTT <br />~ S7/Sl/96 ~S~t3 PEr'HIT ~ .' 96-~4159 <br />; SP STATUS : ISSUED <br />; R-3 ISSUED = S7/S1/1796 <br /> TS EXPZRE -. B7/~1/1997 <br /> PAgE I <br /> <br />WORK DEBt <br /> <br />: RPR;MAJOR DRAIN LINE NOT WORKING <br />~BIITTEVIt. LE RD NE AR <br /> <br />CITY: MARION COUNTY <br /> <br />SUBDIVISION : LOT: BLOCK: <br />CROSS 8TREFT : ST PAUL HWY HE <br /> <br />PARCEL NUMBER : 7579~-~0 PROPERTY 1.0CATOR: 041W30BA0030~ <br /> PARCFi STZE : 1.6AC ZONE: EFU <br /> <br />OWNER NAME : ME~Y~FORREST <br /> <br />APPLICANT <br /> NAME <br /> ADDRFS8 <br /> <br />MEGY.FORREST <br />19436 BUTTEVTLLE R~ NE <br />AURORA OR <br /> <br />678-5995 <br /> <br />PHONE : <br /> <br />CONTRACTOR/ : BEQ LICENSE: <br />A~ENT : OCCB: <br />PHONE : 678-5995 <br /> <br />Un,ts 0ascription , Fee <br />I Rajor repair 1'80.'~F <br />1 ~EQ Surcharge 30.00 <br /> <br /> Assessed fees : 210.00 <br /> Adjustments : .00 <br /> Total fees : 210.00 <br />PAYEE: MEGY~FORREST Total payments: 210.00 <br /> Balance Sue : .00 <br /> <br />lttlS PERHIT IS NDN-TR~FERABLE AND EXPIRES ~5 DAYS FROH ISS~ DATE IF WORK HAS NOT <br />~IE~sOR IF I~ORK FAILS TO 14EET ~L REOUIREI~ENTS OF STATE LAWS AND HARIOH COUNTY <br /> <br />SIGNATURE OF APPI.ICAHT: <br /> <br />DONAL~ E WOOOLEY~ MAR~ON gOUNTY BUll. DING OFFICIAl_ / BY ~FREILI'N~ <br /> <br /> <br />