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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO. 225 <br />220, b~IGH ~'TREET NE <br /> SALC'M, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 RM. - 8:00 A.M. <br /> <br />I am perform~n¢l WOrK on a roperty I own or occupy, <br /> <br />SIGNATURE OF APRLfCANT: <br /> <br /> DATE: <br /> <br />owr~:C~:'f' E: 08/31/99 T'!ME; <br /> ADA;R, RICHARD <br />SITUS ADDRESS: <br /> <br />i0:17:27a <br /> <br />58272--000 <br /> <br />CATEGORY: <br /> <br />OCCUPANCY: <br /> <br /> 9823 MILL. CREEK RD <br />AUMSV ILLE <br /> <br />OR 9?325 <br /> <br />SE <br /> <br />CONTRACT CITY: UGB: <br />MARION COUNTY NO <br /> <br />OOOU PANT LOAD: <br /> <br /> NcO. OF BEDROOMS: <br /> <br />SUBDIVISION: <br /> <br />9S63 HTLL CREEK RD SE <br />ALJf~SV~LLE~ OR <br />RiiONE: 749-2991 <br /> <br />LOT: 8LOCK: SECTION: TOWNSHIP: <br /> <br />STTE NUHSER: <br />VALUAT I ON: <br />RANGE: ZONE: <br /> <br />8 ~ ? 9 <br /> <br />MAP: <br /> <br />WIDTH: DEPTH: AREA: <br /> <br /> ~ ('J UNJTS: ~3$ iRREG. LOT: '! ,,AJ CORN&H: ~" <br />5. 50000 AC NO NO <br /> <br />'TYPE: EL.EC,-FR;[CAL PERMIT OR APFL, ZCATZON NO:: <br /> <br />CONTRACTOR, <br />L;[CENSE NO: <br />ADAIR, R~CHARD <br /> <br />AUMSVILLE, OR <br />PHONE; 749-299'1 <br /> <br />SL P.RVI~IN6, ELECTRICIAN/NLIMEER <br /> <br /> TTE~ <br />MOBILE HONE CONNECTION <br />SLEET SLRCHARGE -ZONE 3 <br />ELEC'TR~CAL STATE SURCHARGf <br /> <br />~UANT'~ TV ANC)UN'[' <br /> 1 $25. <br /> $3.84 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />'THIS RECEIPT <br /> <br />$30, ?,9 <br /> <br /> $0. CE <br /> <br />DALANCE DUE 'i:C C,. <br /> <br /> ,:r-':" :" 8Y- <br /> <br />~ST~CTI~ C~ FOR ~, P~*',:(OF';1,8:0,',DA~;' ~OR' :Z:F~J~ST~CTI~ FAILS TO NE~ ALL <br />REdIReCTS OF STATE <br />~ALL BEdE NULL ~B VOID.',',%:,: :, *,': '; ', .... "' <br /> h,;,, ,, ,, ',:,,~ ' ,, , <br /> <br />~E~ARKS: ~P CON ONLY <br /> <br />90NALD E b~OODLEY NAq~O~.I COUNTY <br /> <br />15.56 ~EV 11/~ OFFICE COPY <br /> <br /> <br />