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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220tHIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 P M - 8::00 AM <br /> <br />DATE: 12/14/89 TIME~. 11:04:04 <br /> <br /> KINNEY, ELVENA <br /> <br /> 12214 NEST STAYTON RD <br />AU~ISVI LLE OR 97352 <br /> <br />SE <br /> <br /> SIGNATURE OF ARPIICANT <br /> OATE <br /> <br /> TAX LOT <br /> CONSTRUCTION TYPE <br /> <br /> CONTFCACT CITY <br /> <br />MARION COUNTY <br /> <br />UGB <br /> <br /> NO <br /> <br />~,~A~LIN~ ~oos~ssSINGLE FA~IILY D~ELLING~ <br /> <br />SAME <br /> <br />PHONE: 769-3126 <br /> <br />LOT /3LOCK <br /> <br />TOWNSHIP <br /> <br />SITE NUD18ER. <br /> VALUATION <br /> RANGE <br /> <br />IRREG LO1 <br /> NO <br /> <br /> 9002 <br /> $500.00 <br />ZONE <br /> <br />CORNER <br /> NO <br /> <br />RESIDENTIAL <br /> <br />TYPE: BUILDING PERi'lIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />KINNEY, ELVENA <br />SAME <br /> <br />PHONE: 769-3128 <br /> <br /> ItEt4 <br />BUILDING FEE <br />PLAN REVIEN <br />FLEET SURCHARGE -ZONE 3 <br />BUILDING STATE EAJRC}4ARGE <br />ZONINGS URCHA~:~E <br /> <br /> 9020?98 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE.~ <br /> <br />OUANTITY <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />AMOUNT <br /> $10.00 <br /> 6.50 <br /> 3.84 <br /> 0.50 <br /> $0.5O <br /> <br />$21.34 <br /> $0,00 <br />$21.34 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: KINNEY, ELVENA ~.~' 22066 <br /> <br /> · THIS IS NOT A PE~IT. ~IS APPLICATI~ ~ST ~ TH~ A R~I~ P~ ~ERE THE <br />FOLL~ING ~ST BE ~PLETEO. IT IS THE R~SIBILI~ OF ~E APPLI~T TO ~RE ~AT <br />ALL N~ARY INFO~N H~ BEEN P~VIDED. <br /> <br />SEPTIC: BY BATE <br />ZONING: BY DATE <br /> <br />RE]V~RKS: DRYROT REPAIR R~6400 <br />HEIGHT: TOTAL ,S~ <br /> <br /> CITY JURISDICTION: BY DATE <br /> <br />SETBACKS: FR LS RS RR ..... SP <br /> <br /> O STORIES: 1 PLAN.ACTION: <br /> <br />F.i:~!M r, Mr: i m=. ~-~. OFFICE COPY <br /> <br /> <br />