Laserfiche WebLink
MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG 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 />I am performing work on a property I own or occupy <br />lam a registered b do OR! he au ho zed ep esen 8 Ye <br />of ~t T'Ogistered builder <br />The work will be pedormed by a registered builder <br />Other <br />I have reed 8nd a~]ree to the terries stated on the reverse s~de of <br /> <br />SIGNATUHE OF APPLICANT <br /> DATE <br /> <br />owi~ArE: 95/23/91 riME: 13:24, t43 <br /> <br /> NAflONAL FORES] LANDS <br />SHUS ADDRESS <br /> <br />fAX LOr <br /> <br />CONSTRUCTION TYRE <br /> <br />HALLS RIDGE 5UIV~i ~ <br /> <br /> CONTRACT OITY <br /> <br />f,,1ARION COUN] Y <br /> <br />PUBLIC NORKS AND UTILiI-i~ 8UiLDI~vls~oN <br /> <br />NO <br /> <br />OCCUPANT LO'AD <br /> <br />DEI NOi] RANGER OiS], <br />HC 60, BOX 320 M~LL CifY 9?360 <br />PHON~: <br /> <br /> SiIE NUC4~,R: <br /> VALUA F 1 ON; <br /> <br />w I f':,¥H DEPTH AREA 08 UNITS 10 IRREG LOT 5E CORNER <br /> NO NO <br /> <br /> 13049 <br />$~.500.00 <br /> <br />104 <br /> <br />IYPgi BUILDING PERMIT OR APPLiCAIiON NO: <br /> <br />CONTRACTOR, NO. ROHN <br />RCHN COMMERCIAL PROlJtJCf5 <br />PO BOX 170249 <br />~iRMiNGBA]'4 AL 35217 <br />[,-'HONE: <br /> <br />~LJILDING FEE <br />PLAN R~¥iEW <br />BUILDING 51ALE ~JJRCHARGE <br />ZONING ~AJRCHARGE <br /> <br />PAYEE: <br /> <br /> 9032419 <br />ARCHiIECYENG~NEER, NO, <br /> <br />PHONE: <br /> <br />T'OIAL ~E~ED FEES <br />PRgWiOUS RECEIPTS <br />THIS RECEIP1 <br /> <br />AI'cOUNI <br /> 158.50 <br /> 103.03 <br /> ~?,,93 <br /> <br />$2'/'z-~9 <br /> $0.00 <br /> $0.00 <br /> <br />BALANCE 0U~ $277.39 <br /> <br /> RECEIVED BY; PB TYPE: CHECK ~: O <br /> <br />~ THUS IS NOT A PER~IlI. THIS APPLiCAtION MUST GO ]HRCOeH A REVZEN PROCg~ WHERE THE <br />FOLLOWING ]h'lUSl ~ C,t~PLEfED. Ir US THE RESPONSiBiLITY OF IHE APPLiCANI fO ~RE THAT <br />ALL NgC~SARY iNFORMA~10N BAS BEEN P~ViBED. <br /> <br />PLAN REVIEW: BY DAIE <br /> <br />CiIY JURISDICIiON: BY DAIE <br /> <br />SEPT lC: BY DATE <br />ZONING: BY OAIE',~--'~""~, ER ~ L5 /~ RS / <br /> ~RK~: Argo CORRB~CA~1~ ~LE 'BAL'-~UE ......... <br /> <br />HEIGHt- v9 fOiAL ~ PT- 0 5'~ORI~: I PLAN.AC~ON~ <br /> <br /> OFFICE COPY <br /> <br /> <br />