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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREE%NE <br /> SALEM, OREG~ON 97301 <br /> <br /> .PHO~ 588-5147 <br /> CODE-A"-~HONE 4:30 P,M. - 8:00 A,M. <br /> <br /> lamaregl~teredbuilderOR( ) the authorized representative SIGNATURE OF APPLICANT; ............................................... <br /> Other <br /> <br />DATE.· 07/22/88 TIME.' 3:41:58p <br /> <br /> HENSLEY. MARIE RESIDENTIAL <br /> ..................................... <br /> <br /> 14070 CESSNA ST NE <br />AURORA OR 97002 <br /> <br />MA~LING ADDRESS <br /> <br /> SUBOIVISION; <br /> SAJNE, E¥ IvcSSILE PARK <br />17585 LANDt.IRA CT NE ......................... <br />AURORA OR 97002 <br />PHONE: 982-4604 SITE NUMBER: 4986 <br /> VALUATION .~ <br /> <br /> 02 48 1W AR 3 <br /> 70 1 O0 ?000 . O0 SF NO ~10 <br /> <br />TYPE: PLUMBING ' PERMIT OR APPLICATION NO: 9009938 <br /> <br />C'CNT~TOR. NO. <br />HENSLEY, I~ARIE <br />17585 LANCURA CT NE <br />AURORA OR 97002 <br />PHONE~ 982~4604 <br /> <br /> ITEM QUANTITY AMOUNT <br />MOBILE HOME SEWER AND WATER CONNECTION 1 $25.00 <br />FLEET SURCHARGE -ZONE 6 $7.68 <br />PLDFE~ING STATE SURCHARGE $1.25 <br /> TOTAL ~ED. FEES $33.93 <br /> PREV[Ot..]$~:RECEIPTS $0.00 <br /> :THIS RECEIPT $33.93 <br /> <br />PAYEE: HENSLE'Y. MARIE RECEIPT NO: 10620 <br />RECEIV _ ,,, ECK mECK <br /> TH[$ IS NOT A PERMIT+ THIS ~[CAT[ON i~JST GO THROU(i~I A REVIEW PROCESS t*~IERE THE <br />FOLLOWING MUST BE O01'4PLETED~ :~[L]TY OF T~E APPLICANT TO A,~SURE 3'HAT <br />ALL NECESSARY [NFORtflAT[ON HAS BEEN:'PROV[DED; , <br /> <br />PLAN REVIEW: 8Y ............ DATE <br />REMARKS: CONN R*t4152 <br /> <br />CITY JURISDICTION: BY ......... DATE <br /> <br />~O~M. MC ~,~ ~:V ~aX OFFICE COPY <br /> <br /> <br />