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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 - 4:30 <br />*24 HO(JR CODE-A-PHONE: 588-7904 <br /> <br /> I am performing work or1 8 property I own or oorttpy, <br /> I 8¢ a registered builder OR ) the authorized representative <br /> of · registered builder, <br /> '[he work will be performed by a registered ~uilder. <br /> Other <br /> I have read and agree to the terror stated on the reverse side of <br /> <br />DATE= 06/22/90 TINE.' 14:~¢6:14 <br /> <br /> ¥'T'EL, DAVE & PAT' <br /> <br />'fAX LOT: <br /> <br />CONSTRUCTION TYPE: <br /> <br /> 91 18 CHAt4POEG RO <br />AURORA <br /> <br />OR 97002 <br /> 144AR .[ ON COUNTY <br /> <br />NO <br /> <br /> PHONE: <br /> <br />lOT; BLOCK: SECTION: <br /> <br />WIDTH: DEPTH: AREA: <br /> <br /> SiTE NUf4BER: <br /> VA LUA T I ON: <br /> TOWNSHIPi ' RANGE,. <br />01 45 2W <br /> NO <br /> <br />9594 <br />EFU <br /> <br />RES,], DENT J. AL <br /> <br />MAP: <br /> <br /> ,? <br /> <br />TYPE: PLUIVf8 .[ N6 <br /> <br />D"r,~I'RAC'I'OR, NO. 34604 <br />JUD,.SON'S INC <br />PO BOX 126~9 <br />SALE, I'4, OR 9'1309 <br />PHONE: 383-4141 <br /> <br />PER~i'r OR APPLICATION NO~ 25112 <br /> <br />NA'fER LINES, 1ST 100 FEET <br />5EWER LIN~, 153' 100 FEET <br />SEWER LINES, EA. ADOL. 100 FEET <br />FLEEr ~JRCHARGE ~ZONE ? <br />PUJf'4EftNG <br /> <br />TOTAL ASSET~£D FE~ <br />PREY/CUB RECEIP'FS <br />THIS RECEIPT <br /> <br />r,~ILIAN'I'I'I'Y AIvlOUN'I' <br />1 $20_00 <br /> 3o.oo <br />1 $15.00 <br /> ~8.96 <br /> 3.25 <br /> <br /> ~AL.N~CE DUE <br /> <br />PAYEE~ JUf:Y~ON~ 1NC RECEIPT NOt <br />RECEIVED ~Y: PB .......................................................... ;~ ........ TYPE: CK ~4ECK ~; <br /> <br />$'??.21 <br /> $0.00 <br />$77,21 <br /> <br />$0.00 <br /> <br />26584 <br />10221 <br /> <br />~ THiS [G A VALID PER~/T * THIG PERrflIT IEXP[RE~ 180 DAYS FR(;t4 [TS I,?~UE DATE. IF <br />COlEL%TRUCT]ONCEASE~ FO~ A PERIOD 0F180 DAYS, OR [PCON~TRUCTZON FAZL.S TO ~EET ALL <br />I;_~I~TS OF STATE ~ AND I~ARION COUNTY BUILDZNEi AND [~N1N~ ORDINANCES, THIS PERIflIT <br />:.'.'.'.'.'.'.'.'.T;J'tALL BECOIVlE NULL AND VOID. <br /> <br />REt4ARKS: NAT'ER/ SEllER LINES R"C21zV~' <br /> <br />DONALD E. I,~-SVODLEY, 1~4ARJON COUNTY BUILDING OP'F,[C.tAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />