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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 295 <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 />Other <br /> <br />SIGNATURE OF APPLICANT <br /> OATE <br /> <br />10/18/91 .... '~iNE: <br /> <br />GIBSON, OLE'fTA <br /> <br /> 307 C~URC,'H <br /> AUMSViLLE OR <br /> <br />USE OF BUII:DING~ .......... <br /> <br />MAILIN~ ADDRESS: ~INGLE FAJVlI'UY DNIELLIN~' <br /> <br />PO 8OX 855 <br />AUMSViLLE 97325 <br />PHONE: 749-1464 <br /> <br />LOT: <br /> <br />W~DTH: <br /> <br /> 90080-200 <br /> <br />........................ 5._-/N ........................ ~_~.3 ........ <br />Au v, t, E ............ ......... : ................ <br /> <br />'~AT~GORY. <br /> <br /> RESI DENT IAL <br /> <br /> SUBDIVISION; <br /> <br />........................ htERRi. EL[ ~'1 I'~S~O~_ ........................... <br /> <br />5 ~ ...... L .... 25-- 85 2~ pM <br /> iDEPTH: ARE,~ J NITS. IRR~C~. LOT CORNER <br /> 100i 108 10800. ...._.~p~_ .............. _N_O. ......... YES <br /> <br />RANGE ' ' <br /> <br />TYPE: BUILDING <br /> <br />CONI'RACTOR, NO. <br />GIBBON, OLETTA <br />PO BOX 855 <br />AUP1SVILLE 97~25 <br />PHONE: 749-1464 <br /> <br />PERC41'f OR APPLICATION NO: <br /> <br /> ITEM <br />BUiLDiNG FE~ <br />PLAN RS¥iEW <br />BUILDING S'I'A'I'E SURCHARGE <br /> <br /> 9036203 <br />ARCHiTECT/ENGINEER. NO. <br /> <br />'FOTAL~%S.E. SSEDFEE~-& <br />PRE¥iCUS RECEIPTS' <br />THIS RECE:~PT <br /> <br />BALANCE DUE <br /> <br />r~JANT i I'Y <br /> <br /> AIV~U N I <br /> <br /> 25.03 <br /> $1_93 <br /> <br /> $85.46 <br /> $o.oo <br /> $85_46 <br /> <br /> $3.06 <br /> <br />38131 <br /> U <br /> <br /> PAYEE: GIB~¢4, OLE1'f'A ~') <br /> REOEZVED BY: PB ............................................................................... ..~.._ ~' · 'TYPEt &N CHECK ~: <br /> <br />~ THiS i~ NOT A PERMI1. THI~ APPLICA ION f~IUS~.GO. IHR01¢GH:~.REViEN PROC~ ~ERE I'HE <br />FOLL~ING ~T ~5 ~NPLETED. IT I~ rHE R~I. BiLiTY CE THE APPLi~'Y f'O ~RE fHAI <br />ALL NECESSARY INFO~I'I~ H~ BEEN P~ViDED. <br /> <br /> Ci'T'Y JURISDICI'iONt BY <br /> <br />SEP'f'tC: BY .......................................... DATa ......................................... <br /> <br />ZONING: BY DATE SETBACKS: F'R 20 LS B RS 20 RE 8 <br />REr4ARKS; UT'IE'ITY'"'~QO¢4 AD'DR ..................... <br /> <br />HEIGHT; 11 FOTAL ~SQ Fl: 320 <br /> <br />.ACTION: <br /> <br />DAI'E <br /> <br />OFFICE COPY <br /> <br /> <br />