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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 L.~mg;~mter Dr. N.E. · SuRe C * Salem, Oregon 97305-1398 <br />Office Houm: 8:00-4'30 · 'Phone: (503) 588.5147 · 24-HR Inspection Line: ($03) 373-4427 <br /> <br /> ~UILD~I~ ~PPLICATIGH <br />~TE/TIHE : ~3/13/97 B9=42 .. ~TZ~ITY ~ ~ 97-E11~ <br />TY~ : Res~denttal acc~ry struct STAT~ : CANC~ <br />C~ : ~LI~ = B2/2~/1~7 <br />~ ~ U-1 TO ~PI~ ~ ~/13/19~7 <br />C~T~TI~ ~ V-N P~E 1 <br /> <br />V~[ U~T~OH : $19~ 914.48 <br /> <br />~ORK DE~C : G~R~GE 2/C~R <br /> <br />SITE A~D~FSS : CITY: MARIOH COUNTY <br /> 11920 FARGO RD NE~R <br /> <br />CROSS STREET : BENTZ RD <br /> <br />PARCELrNUMBER : 71228-14~ <br /> PARCEL SIZE : 3.57 AC <br /> <br />OWNER NAME <br /> <br />APPLICANT <br /> NAME <br /> ADBRESS <br /> <br /> PHONE <br /> <br />CONTRACTOR/ <br /> AGENT <br /> PHONE <br /> <br />: HAWORTH, DOHALD W & BARBARA L <br /> <br />: VAN LIEU ROGER WAYNE <br />: 21487 OAK LN NE <br /> <br />AUS~RA. OR 97802 <br />678 5432 <br /> <br />VAN LIEU ROGER WAYNE <br />VAN LIEU ROGER WAYNE <br />678-5432 <br /> <br />OCCB: 0800212 <br /> <br />TOTAL SQ FEET : 1,224 1ST FLR= 1224 2ND FLR: 3RD FLR: <br /> GARAG~E~. BASEMENT: OTHER: <br />STORIES: 1 HEIGHT: 2~ <br /> <br />Onitsei- ~es:rietion- ~ . Fee <br /> uu~iuzng ~ee ~ 140.~u <br />1.8 Plan Review Fee 91.33 <br /> 1 <br /> State surcharge 7.03 <br /> 1 ~one surcharge 7.83 <br /> I R~fund -119.4~ <br /> <br /> Assessed fees : 126.46 <br /> Adjustments : .88 <br /> Total fees : 126.46 <br />PAYEE: VAN LIEU ROGER WAYNE Total payments: 126.46 <br /> Balance due . .88 <br /> <br />SIGNAIURE OF APPLICANT: <br /> <br />OONAL~ E. WOODLEY, MARION COUNTY BUILDIHG OFFICIAl / BY <br />........... L .................. L___ FOR O~FICE USE ONLY ......... ..~,_~_~ff"%/~ ...... <br />SITE / UGB: · <br /> MAP : 4 ZONE: EFU PROPERTY LOCATOR. 041W~P;CD82788 <br /> LAND USE: <br />REQO o~IBACKS. Front: Left: ~ight: Rear: Special: <br /> <br /> <br />