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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 />Other. <br /> <br /> I have read and agree to the terms stated on the reverse side of <br /> <br />DATE: 06/17/66 TIME: 9:53:02a <br /> <br /> .HAPWGSKE. v'~.,~- & GERTRUDE <br /> <br /> LOT. CATEGORY <br />3ONSTRUCTION TYPE OCCUPANCY <br /> <br />.... S. ,.E~, T. A <br /> <br /> 9664 SILVER FALLS HWY <br />ABMSVZLLE OR <br /> <br />USE OF BUILDING: <br /> <br />97325 <br /> <br />SE <br /> <br />CONTRACT CiTY UGB; <br />M~RIO~ COUNTY NO <br /> <br />OCCUPANT LOAD <br /> <br />MAILING ADDRESS <br /> <br /> SAME <br /> <br /> PHONE: <br /> <br />LOT <br /> <br />WfOTH~ <br /> <br />BLOCK SECTION' <br /> <br />'8 <br /> <br /> SITE NUFBER: <br /> VALUATION: <br /> <br />86 1~ ARS <br /> <br />MAP' <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR. NO_ 38238 <br />SANTIAM VALLEY HOMES <br />11373 MiLLCREEK RD SE <br />AUMSVILLE OR 97325 <br />PHONE~ <br /> <br /> iTEM <br />MATER LINES, 1ST 100 FEET <br />f~OBIL. E HOME SE~ER AND MATER CONNECTION <br />PLUMBING B,~SE FEE <br />FLEET SURCHARGE -ZONE 3 <br />PLUMBING STATE SURCHARGE <br /> <br />TOTAL ASSESSE0 FEES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br />1 $20.00 <br />1 $25_00 <br /> $28_80 <br /> $3_94 <br /> $3,25 <br /> <br />~'72. O9 <br /> 72,09 <br /> $0-00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE; RECEIPT NC}: <br /> <br />RECEIVED BY: ,.J8 TYPE: CHECK a: <br />~ THIS I$ A VALID PERMIT * THIS PEENIT EXPIRES 180 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS, OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LAWS AND MARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PER~4IT <br />SHALL BECOME NULL AND VOID. <br /> <br />REMARKS: WL & S~N CONN R~6359 :' <br />DONALD E. NOODLEY. MARION COUNTY BUILDING OFFICIAL/ 8Y <br /> <br />rOR~ ,, r~c ~,.~.~ ~v e¢87 OFFICE COPY <br /> <br /> <br />