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SENATOR BLDG, NO. 225 <br />220 HIGH STREET NE <br />SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />OWN~)~'I'E: 05/17/9D TINE: 15:47:015 <br />S~TUSAODNSSS'|'AR].LTON. GLEN P <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE: <br /> <br />557? OUMORE DR <br /> <br /> CONTRACT CITY <br /> <br />.... ©R. -.9,7325 ........... <br /> ¢,tARiON CY,:,'U N T Y <br /> <br />MAILING ADDRESS <br /> <br />OTHER NOfq-RESiOE~'IriAL BUiLOINE¢~ <br /> <br />NO <br /> <br />CATEGOR~ <br /> <br />OCCUPANCY: R~S[ DEN'f iAL <br /> <br />OCCUPANT LO~ <br /> <br /> SAME <br /> <br />LOT: <br /> <br />370-9226 <br /> BLOCK <br /> <br />SECTION ' TOWNSHIP. <br />AREA. ] .~ UNITS <br /> <br />SITE NUMBER: 11Q'? <br />R^NOCALUAT iON: ZONE <br /> <br />~ RREG. LOT: 2[~ CORNER AR3 49 <br /> <br />NO [40 <br /> <br />TYPE: BUILDING <br /> <br />CON fRACTOR, NO'. <br />'rARiLTGC{, GLEN P <br /> <br />PHONE: 370~9226 <br /> <br />PEN'~II'r OR APPLiCATiON NO: 23?22 <br /> ARCHI'fECT/ENGiNEER, NO. <br /> <br /> ITEM <br /> BUiLDiNG FEE <br />~,PLAN <br /> FLEET SURCHARGE -ZONE 3 <br /> ~UtLDtNG S'f'ATE SUNX,~ARGE <br /> ZONING ~URCHARGE <br /> <br />PAYEE: <br /> <br />TO'rAL~EO FEES <br />PREYtCUS RECEIP'fS <br />'[Hi'S RECEIPT <br /> <br />QUA¢4 T l TY <br /> <br />$44.53 <br />$3.94 <br />~3.43 <br />3-A3 <br /> <br />$123,73 <br /> $o.oo <br /> <br />BALANCE BUS $0.00 <br /> <br /> RECEIV£D BY: dm ....................................................................... TYPE: CHECK At: 0 <br /> <br />· l'Hl~ iS A VALID PERMIT * THiS PER~IT EXPiRE~ 180 DAYS F'~ ITS I~E DATE. iF <br />~ST~CTi~ C~ES FOR A PERIOD OF 180 DAYS; OR iP ~ST~CTI~ FAI~ 'f'O NEET ALL <br />RE~iRE~EN'Y'5 OF STATE ~ ~D ~Ri~ ~NYY BUILDING ~D Z~ING ORDiN~C~, 'fH15 PE~]) <br />SHALL BEC~E NULL ~D VOID. <br /> <br />SETBACKS: FR ~'* LS 9 RS 9 RR g SP <br />RE~.RKS: **'BARN I~uST BE LiZYCA'FEO-'F.~3'4TiREE%"BENiND RESIDENCE+ APPROVED FOR PRIVATE <br /> NONCOhY~ERCIAL USE ONLY <br />HEIGHT: 19 TOTAL ~ F'r: 2400 STORIES; 1 PLAN.ACTION: <br /> <br />DONALD E. W~ODLEY, {VtARiON COUNTY BUiLOiNG OFFiCiAL / BY <br /> <br />FORM # MC 15-56 REV. 4/90 <br /> <br />OFFICE COPY <br /> <br /> <br />