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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 <br />CODE-A-PHONE 4:30 P,M. - 8:00 A.M. <br /> <br />The work will be performed by ~ registered builder. <br />Other <br /> <br />S~GNATURE OF AR~LICANT; <br /> <br /> CATE: <br /> <br /> TAX LOT: <br /> <br />OWNE.: $ANDSTRL~, EDG;~R 3, <br /> <br />SITUS ADDRESS: CONSTRUCTION TYPE:5N <br />5577 DUIsDP~ DR SE <br />AUMSVI[,I,E OR 97325 ' C~N~8~ ~;~ ' U~: <br /> <br /> O~ ~ ~ F~ILY <br /> <br />~: 364-6731 SI~ ~: <br /> <br /> O¢CUPANCYR~ <br /> <br />'OCCUPANT LOAC: <br /> <br /> 3 <br /> <br />LOT: ' I~LOCK[ : SECTION: i TOWNSHIP: RANGE: <br />WIDTH: DEPTH: ' AREA; UN~'J'~: I~REG. LO'C; <br /> <br />CONTRAC"i~R, NO. <br /> <br /> zoNE: <br /> <br />: dORN~R; N <br /> <br />MAP: <br /> <br />ARC~ITECT/ENGIN~, NO. <br /> <br />PRE)NE: PHONE: <br /> <br /> IT~W <br />BUILDING FEE <br />PLaN REVIEW4 <br />Fr,~.~T SURCHARGE -ZONE 3 <br />STATE S~E <br />ZONING SURCKa~GE <br /> <br />PAYEE: SANDSTRUM, EDGAR <br />RECEIVED BY: CL <br /> <br />FOLLOWING ~JST BE COMFLEiI~. IT <br />ALL ~ I~%~TIC~ NAS __ <br />PLAN REVIEW: B~ <br />SEPTIC: BY <br />ZONING: BY~ DATE <br />R~4ARKS: F~T.'//~4' ~' ~! !:~ ':~ <br /> <br />QUANTITY A~0UNT <br /> $74.50 <br /> 848.43 <br /> 3.84 <br /> 2.98 <br /> 3.73 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RFLIE IPTS <br />THIS P~EZPT <br /> <br />$133.48 <br /> $o,oo <br />$133.48 <br /> <br />]~LANCE DUE <br /> <br />$0.00 <br /> <br />INVOICE NO: 2115 <br />TYPE: C~ OHECK#: 1077 <br /> <br />A REVIE~ P~OCESS ~ERE THE <br /> TBE APPLICANT TO ASSURE TMAT <br /> <br />DATE <br /> <br />OFFICE COPY <br /> <br /> <br />