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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:: 588-8147 8:00 - 4::30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />StJl IkR. RALPH <br /> <br />~ITU~ ADDRESS <br /> <br /> 915 9fH 3' <br />~DJv~3\/i LI. t: OR 9.325 <br /> <br />5±NGLE FAMILY DWkLL, iNG5 <br /> <br /> BOX 12533 <br />~ L~4 OR 9/309 <br /> <br />BLOCK SECTION TOWNSHIP <br /> 4 2__5 <br /> <br />SIGNATURE OF APPLICANT <br /> DATE <br /> <br /> TAX LOT <br /> <br /> CONSTRUCTION TYPE <br /> <br /> GONTRACT CITY <br /> <br />AU~MSV i LLE <br /> <br />UGB <br /> <br />NO <br /> <br />CATEGORY <br /> WESi DEN I LAL <br /> <br />OCCUPANCy <br /> <br /> 1.4~-::3 <br /> <br />DELNI$R ADDiflON ~3 <br /> <br /> SiTE NUMSkR: <br /> VALU~ f iON: <br /> <br /> RANGE <br /> <br />85 2~ <br /> <br /> IRREG LOT <br />SF NO <br /> <br /> 13663 <br />$4b,L}fgO 00 <br /> <br />IYi>L,, LTciLLLiNG RERMiT OR APPL.!CAflQN NO: <br /> <br />RALPH 5UI f~R <br />:<) BOX 121,33 <br />bALEM 9/309 <br />~>H()N B, 588-23/3 <br /> <br /> i ¥ <br />OIAIb, L,L, iNB bUILDING Fc,.E <br />DWELL ~NG PL, Ulflb <br />L)W[; LL lNG ~!ECH~N ! L,'A L <br />O~ELLII',I¢~ P_.LF.:.C fRICAL <br />O¢,*¢kLLiNG 51A/E 5LiRCHARG~ <br />OWELI_iNG PLAN REVIEW <br /> <br />R~Yb,~- <br /> <br /> 34810 0P <br />AR%HI/ECf/BNGINb~N. NO. <br /> <br />PH ON E: <br /> <br />1OTAL A~ESSED F~E5 <br />PREVIOUS RECEiP¥~ <br />[HiS R~O~IPf <br /> <br />¢.!U ,tN I I Y <br /> <br />AMOU N 1 <br /> $20~, 49 <br /> $?6, SS <br /> $39,,03 <br /> <br /> $18,23 <br /> <br />$5t7. ?9 <br /> $o 00 <br /> <br />blAL.,&NCE DUE $C_ 00 <br /> <br /> RECEIVED ,¢,,Y; uL1 TYP~.: CHECK ~: 0 <br /> ¢ IHt5 i~S & ,/AL_2 PERMIf ~ IHi5 PEril F 'J ~"' <br />rZ)N~IRUCFiON CE.ASE5 FOR m PERIOD O~ 180 DAYS, OR iP CONSiRUCIION PALL5 IO ~I~E~ AL, I, <br />K:LQUiREIVlENI5 OP 5TA'IE LA~o AND ~ARION CQUNfY BUiLDiNG 4~D ZONING ORDINANCe5, TH!5 RERMI~ <br />5HAIL L~EOO~E NIIL. L AND VOID. <br /> <br />-I~/GHf' i4 f,gTAL 5Q PT: 1302 ."='?I.)RI. bS- I <br /> <br />DON/~,ID ,h,, Nf-.)ODLEY. lVlAR]rjrx CO,-N Y BUiL. IJINr.:~ Ot'-PiCiAL / BY <br /> <br />LAN. ,~.(~ T J ON , <br /> <br />FORM # MC 1556 REV 4/~0 OFFICE COPY <br /> <br /> <br />