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MARION COUNTY <br /> BUILI2qNG INSPECTION <br />Senator Building · 220 High Street NE · Second Floor · Salem. Oregon 9731)1-367/I <br />Office Hours: 8;00 - 4;30 Phone: 588-3147 Code-A-Phone: 4:30 ]>,ill, - 8:00 a.m <br /> <br />DATE: 07/28/88 TIME: 2: 34.* 57p <br /> LANE, JACK <br /> <br />RESIDENTIAL <br /> <br /> 6104 SHAW LANE SE <br />AUNSVILLE OR 97325 <br /> <br />1,4ARION COUNTY NO <br /> <br />PHONE: 749-294'1 <br /> <br />SITE NUMBER: 5027 <br />VALUATION: <br /> <br />175 748 <br /> <br /> 24 8S 2N AR3 <br />130900_ SF NO NO <br /> <br />51 <br /> <br />TYPE: pLDIVI~ING <br /> <br />PE~IT OR APPLICATICN NO: <br /> <br />CONT~CTOR, NO- 38238 <br />SANTIAN VALLEY HONES <br />11373 NILLCREEK RD SE <br />AUNSVZLLE OR 9?325 <br />PHONE: <br /> <br /> ITEM <br />SEWER LINES, 1ST 100 FEET <br />MOBILE HOME SEWER AND WATER CONNECTION <br />FLEET SURCHARGE -ZONE 3 <br />PLUMBING STATE SUROdARGE <br /> <br />901005? <br /> <br />TOTAL A,,,RSEE~EO FEES <br />PRE¥IOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br />1 $30.00 <br />1 $25.00 <br /> $3.84 <br /> $2.75 <br /> <br />$61.5§ <br /> <br />$61+59 <br /> <br /> BALANCE DUE $0.00 <br />PAYEE: SANTIAM VALL~'f HOMES ~%% RECEIPT NO: 10743 <br />RECEIVED BY: DM .............. ~ ...... TYPE~ CK ~{EOK ~: 8924 <br /> <br />~ THIS IS NOT A PEI~ZT. TH~S APPLI~T~ ~ST ~ ~ A R~ P~ ~ERE THE <br />FOLL~[NG ~ST 8E ~PL~ED. IT IS ~E R~SIB[L~ OF ~E APPLI~T TO ~RE ~AT <br />ALL NEC~ ~NFO~T[0N H~ BE~ P~V[DEB. <br /> <br />PLAN REVIEW: BY ............ BATE <br />REMARKS: CONN & SL f~4223 <br /> <br />CITY JURISDICTION: 8Y <br /> <br />DATE <br /> <br /> <br />