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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALFM, OI~EGON 97301 <br /> <br /> PHONE:: 588-5147 8::00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />of a registered budder <br /> <br />Other <br /> <br /> I ha~u read and agree to the term8 8tsted on the reverse 81de of <br /> tins document <br /> <br /> OAIE; 10/23/90 'T'iME: 10:31:20 <br />OWNER <br /> NICHOL, GLEN E. <br /> <br />SIGNATURE OF APPLICAN~ ~ ~ <br /> <br />CATE <br /> <br />CATEGORY <br /> <br />OCCUPANCY <br /> <br />RbSi DEN riAL <br /> <br /> 8420 HOLM~UtSf ND ~E <br />AUIV~VILLE OR 87325 <br /> <br />USE OF SUIL01NG <br /> <br />MARION COUN[Y NO <br /> <br />AU~SVILLE, OR 9. 325 <br />RHONE: 585-1782 <br /> <br />LOT BLOCK SECTION TOWNSHIP <br />1.77 <br /> <br />8S <br /> <br />AC <br /> <br />5i¥E NUMBER: 11405 <br />VALUA f IH~: <br />RANGE ZONE MAI, <br /> 1~ AR 48 <br /> YE~ NO <br /> <br />TYPE: PLUMING <br /> <br />PEk?alT' OR APPLiCA]ION NO: <br /> <br />CON~RAGIOR, NO. <br />NICHOL, GL~ E. <br />9748 8AT~5 RD SE <br />AUf4,5¥1LLE, O~ 97325 <br />PHONE; 585-1782 <br /> <br /> I 'l EM <br />WAFER LINES, 1SI 100 FEET' <br />WAIER LINES, EA. ADDL. lO0 FEEl <br />MOBILE HOME SEWPR AND WATER CONNECTION <br />FLEEI ~I~HA~E -Z~E 3 <br /> <br />9028242 <br /> <br />QUANIiTY <br /> <br /> 3 $45.00 <br /> 1 <br /> $3_84 <br /> $4 <br /> <br />TOTAL A..,~E,SSED PEELS <br />PREVIOUS RECEIPIS <br />THiS RECEIP'T' <br /> <br />$98.34 <br /> $o.0o <br />$98_3~ <br /> <br />BALANCE f~JE $0. O0 <br /> <br /> PAYEE: NiCHOL. GLeN ~ RECEIPT' NO: 29843 <br /> RECEIVED MY: cl FYPE~ CK CHECK ~: 181 <br /> <br />* THiS 1~ NOT A PERMIT, THiS APPLiC~ATI~ D!UST GO THRf.~J(~ A R~IEW PREX~ ~tERE THE <br />FOLL(THING BE COMPLETED. iF IS TH~ R~PON~i~iLiTY OF THE APPLICAN¥ TO ~R~ THAT <br />ALL N~.(~E~i"""""""""""""""~ARY INFORD1ATI(~N H~ B~F_J~ P~ViDED. <br /> <br />PLAN REVIEW: BY OAfE <br /> <br />REMARKS: ~fl CON, WL R~A248 <br /> <br />CI'IY JURiSDICTiON: BY <br /> <br />OFFICE COPY <br /> <br /> <br />