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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO 225 <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 />SIGNATURE OF APPLICANT <br /> <br />12/19/90 <br /> <br />NiCHOL, GLEN <br /> <br />15:12:05 <br /> <br />TA~ LOT <br /> <br />CONSTRLJCTIO N TYPE <br /> <br />5B363-0OO <br /> <br />R~-.Ei DEN I ,tAL <br /> <br /> 8420 HOLIVlrJUIS[ RD <br /> AUC~VI LLE <br />USE OF BUILDING <br /> <br />OR 97325 <br /> <br />I~,ARION COUN FY NO <br /> <br />SUBDIVISION <br /> <br />AU~VtLLE, OR 9'/325 <br />PHONE: 585-1782 <br /> <br />LOT BLOCK SECTION <br />WIDTH DEPTH AREA <br /> <br />1. ?7 <br /> <br />TOWNSHIP <br /> <br />UNITS <br /> <br /> SiTE NUMBER:. <br /> VALUA ION: <br /> <br />8S "tN <br />AC YES <br /> <br /> 11405 <br /> <br />ZONE <br /> <br /> NO <br /> <br />MAp <br /> <br />48 <br /> <br />IYPE: PLUIV~ 1 N6 <br /> <br />PERI~I'I OR APPLiCATiON NO: <br /> <br />28242 <br /> <br />coNr RAC I OR, NO. <br />NiCHOL, GLEN E. <br />9?48 BALES RD ,SE <br />AU~¥ILLE, OR 97325 <br />PHONE: 585-1 Y82 <br /> <br /> 11 EM <br />NA'f'ER LIN~, 1Er 10o FEEt <br />~NAIER LINE,~. ~. AODL. lO0 FEEl <br />~ILg H~E S~ER AND WAFER ~NEC'f'i~ <br />F'LEE1 SU~HA~E ~Z~E 3 <br />PLUmiNG STATE ~A~E <br /> <br />TOTAL A~S~ED FEE5 <br />PREVIOUS RECEi Pl S <br />THi~ RECEIPT <br /> <br />(.~AN f' I fY A~40UN [ <br />1 $20.00 <br />3 $45_ 00 <br />~ $25.00 <br /> $3.84 <br /> $4.50 <br /> <br />$98.34 <br />$98_34 <br /> $8.0o <br /> <br />BALANCE BJE $0.00 <br /> <br />RECEIPT NO: <br />CHECK ~: 0 <br /> <br />PAYEE: <br />RECEIVE0 BY: pr TYPE: <br /> <br />* THiS lSA VALID PEF~iT :¢ THIS PEF~IIT EXPIRES 180 DAY~ FRO~ ITS iSSUE DATE. <br />CONSTRUCTION CEAS~ FOR A PERIOD OF 180 DAY~, OR IE CONSTRUCTION PAIL~ fO ~IEET ALL <br />_..REQU.. [REI¥1ENTS OF STATE ~ ANO t~ARION COJNTY EAJILOING ANO [ONING OROINANC~.~, THIS <br />.SHALL BECOME NULL AND VOID. <br /> <br />RblW, ARK$.* MH CON, <br /> <br /> OFFICE COPY <br />FORM # MC 15-~6 REV 4/90 <br /> <br /> <br />