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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO,, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 9"[301 <br /> <br /> PHONE: 588-5147 8::00 - 4:30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br />OWN~rE: 06118/91 'TIME: <br /> S~ERLEY, 1VAN <br /> <br />TAX LOT <br /> <br />CONSTRUCTION TYPE <br /> <br />57705/57'~07 <br /> <br />CATEGORY <br /> <br />OCCUPANCY <br /> <br />RESiDEN i iAL <br /> <br /> 110 SPRUCE <br />AUMSVILLE <br /> BUILDING <br /> <br />97325 <br /> <br />I ~ CONTRACT CITY <br /> <br /> AUr~VILLE <br /> <br />UGS <br /> <br />NO <br /> <br />OCCUPANT lOAD <br /> <br />SUBDIVISION <br /> <br />11373 MiLL CRE~K RD <br />AUM~VILLE <br />PHONE: 769-?744 <br /> <br />EVERGREEN MOBILE ESYAiES <br /> <br />SIlE NUMBER: 13254 <br />VALUA I iON:, <br />RANGE ZONE <br /> <br />WIDTH 15 DFPTN AREA ~ UNITS <br /> 55 91 5005. <br /> <br />8~ IRREG LOT 2W CORNER <br /> <br />SF NO I NO <br /> <br />PLUMBING PERMII OR APPLICATION NO: 32916 <br /> <br />CONIRACIOR, NO, 38238 <br />~AN[iAM MOS IL~ HOMP~ <br />11373 MILLCREEK RD SE <br />AUF~VILLE OR 97325 <br />PHONE: ?59-7744 <br /> <br /> ir~M <br />I"A.'~ILE HOME S~WgR AN~ V',~[ER CONNECTION <br />PLUMBING SIAi~ ~URCHARGE <br /> <br />QUANiIIY A~OUNl <br /> 1 $25.00 <br /> $1.25 <br /> <br />FO'fAL A.S~E~ED FEB <br />PR~¥IOOS RECEiPIS <br />THIS RECEIPf <br /> <br />~26.2b <br /> 28,25 <br /> $0.0O <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: INVOICE NO: <br /> RECEIVED BY: CL TYPE: CHECK ~: 0 <br />* THIS IS A VALID P~I~11T * THIS P~RMIT EXPiR~ 180 OAY~ FROM ITS I~ ~T~. IF <br />~T~I~ C~ ~R A P~IOO OF 180 ~. OR IF ~T~CTI~ FAI~ TO ~EET ALL <br />~I~T~ OF ~TATE ~ ~O ~l~ ~NTY BU[~I~ ~O Z~ING ORDINal. THIS ~iT <br />~LL B~E NULL ~O~lO. <br /> <br />RgMARKS: ~ CONN <br /> <br />DONALD g. WOODLEY, MARION COUNiY BUILDING OFFICIAL / BY <br /> <br />FORM # MC ~5-56 REV 4/90 OFFICE COPY <br /> <br /> <br />