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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 9'7301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: ~88-7904 <br /> <br />Other <br /> <br /> have reed af~d agree to the terms stated on the reverse side of <br /> ti]is document, <br />DA"rE: Q9/26/90 'll~4E: ']2t30:66 <br /> <br /> CLARK, ~AR f'~N <br /> <br />Stf3NAh'URE OF APPLICANT;~. <br /> DATE: <br /> <br /> 5-N <br /> 20521 8OONE$ f::F..RRY RD NE <br />AURORA OR ,~'F002 , CONTRACT CITY; UGh: <br /> ~AR~oN CCYJN ~ Y <br /> <br /> R~IOEN'FiAL ACCESSORY STRUCTURES <br /> <br />P.O. BOX 168 <br />AURORA, OREGON 97002 <br />PHONE: 578-1139 <br /> <br />SI 'T'E NU¢48 ER: <br /> VALUA'f IL)N: <br /> <br />NO <br /> <br />OGOUPANT LOAD: <br /> <br /> NO OF BEDROOMS <br /> <br />335? <br /> <br />TowN'NIP: ' RANGE: ZONE: <br /> <br />UNITS: )RREG LOT NO ;CO~N.~O <br /> <br />MAP: <br /> <br />TYPE; BUILDING PERMIF OR APPLICATION NO: <br /> <br />CON'( RACTOR, NO. <br />CLARK, MARTIN <br />P,O. BOX 168 <br />AURORA, OREGON 97002 <br />PHONE: 678- l 'l 3Fi <br /> <br />EfUI L.E)iNG FEE <br />PLAN REVi EN <br />FLEE'[' SUR~C. HAkX~E -ZONE <br />BUiLDiNG ~'f'A'I'E SURCHARGe' <br />ZONING SURCHARGE <br /> <br /> 902753.3 <br /> <br />ARChi 1 'f EC"K/ENG I NEb. R, NO. <br /> <br />PHONE: <br /> <br />'[O'i'AL~ED~EES <br />PR~,/IOUSRECEiP'f5 <br />THiS REOElP'I' <br /> <br />AMDUN ~ <br /> $92,50 <br /> <br /> $4. ~3 <br /> <br />$ ') ~9- 57 <br /> $0.0U <br /> <br />E4ALANCE 0UB .~ G. ~L) <br /> <br /> PAYEE; ((:LARK, NC-.R'I'IN '"~ '~ 2912¢ <br /> <br />~ !'HIS i~ NOF A PER~'~'. THiS APPLICATION 1'4UST (;¢O ]HROUGH A REViEN PROCESS NHER8 <br />FoLLrjNING ~,~3S'I' t~ COMPLETE0. iT tS THE R~PC'NS[B/rL.f.T¥ OF THE APPLICAN'I <br />AL[. NECESSARY JNFOR~IA'I'tON HAS BEEN PRQVZBF~D. <br /> <br />CZ'f'Y JURiSOIC'FiON: 8Y ................... DAlE .......... <br /> 1~ PLAN.ACf'iON: <br /> <br />OFFICE COPY <br /> <br /> <br />