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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 />Other ........ <br /> <br />DATE <br /> <br />OWN~lg; U5/28/91 llf4g: 12;30:55 <br />SITUS AL~DRP--S~GAf KO [~)NALD J. <br /> <br />TAX LOT CATEGORY <br />CONSTRUCTION TYPE 902b0-475 OCOUpANCY <br /> <br />150 ~Of f AVE <br /> <br /> CONTRACT CITY <br /> <br />DEl ROI l <br /> <br />NO <br /> <br /> P_O. 8OX 5'!'! <br /> <br /> PHONE; <br />LOT BLOCK <br /> <br />SUBDIVISION <br /> <br /> PAllON 2NO AODiIlON <br /> <br /> SI1E NUC~BER: 13089 <br /> RANr~,LUA'¥iON: 7ONE <br /> <br />WIDTH 1/2 DEPTH 5 AREA '1 UNITS l0 IRREG LOT 5E COMNFR k¥~ <br /> <br />fYPE: PLUIV~ING <br /> <br />PER.~.~.~.~.~.~.~.~IT OR APPLICAflON NO: <br /> <br />CONtRACIOR, NO. 36421 <br />KEViN'S BACKHOE SERVICE <br />P.O. ~(.)X 485 <br />D~fROIf. OREGGN 9?342 <br />PHONE: <br /> <br />WAFER LINE5, lSf 100 PEEl <br />~O8iLE HGME bbNER AND WAIER CONNECIlON <br />PLUMBING 5fAf~ SURCHARGE <br /> <br />9032508 <br /> <br />fOlAL ~E~ED FEES <br />PREVIOUS RECEIPTS <br /> <br />QUAN/I/Y <br /> 1 <br /> t <br /> <br />BALANCE DUE <br /> <br />PAYEE: KEViN'S BACKHOE SERVICE <br />RECEIVED ~Y; pP ............................................................. <br /> <br /> iNVOICE NO: <br />fYPE: iN CHECK <br /> <br />RESIDD:NIIAL <br /> <br />MAP <br /> <br /> ~20.00 <br /> 25.00 <br /> $2_25 <br /> <br /> $4'! - 25 <br /> $0,00 <br /> $4 Y - 25 <br /> <br /> $0. O0 <br />34299 <br /> <br />* THIS IS NOT A pERMiT. THiS APPLiCATiON MUST GO THROUEH A REVi~ PROCIgSSt~ERE THE <br />~OLLJO~ING f~JST B~ ~L~TED. IT IS THE RESPONSiBILiTY OF THE APPLIC~T TO A~RE THAT <br />ALL NECE~RY INFOI~D1ATION HAS ~EEN PROVIDED. <br /> <br />PLAN Rb¥iEW: BY .............. DAf'E ......................... <br /> <br />Rg~RK5: N/S CONN & WAIER LiNE <br /> <br />CifY JURISOiCliON: 8Y .... GAIB ...... <br /> <br /> OFFICE COPY <br />FORM ~ MO 1 ~-G6 REV 4i9o <br /> <br /> <br />