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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;:: $88-$147 B::00 - 4::30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />SIGNATUR£ OF APPLIGANT <br /> DATE <br /> <br />OWN~I~2: 07/19,/91 liME: 11:05:35 <br /> GREEN,. JO¢: <br /> <br /> AU F.%)RA OR 9700~ <br /> <br />TAX LOT <br />CONSTRUCTION TYPE <br />'CONTRACT C~TY <br /> <br />f~ARI ON COUN l Y <br /> <br />NO <br /> <br />CATEGORY <br /> <br />OCCUPANT <br /> <br />NO OF BEDROOMS <br /> <br />M*,L,M~ ~Dr~n~SS R~IDEN'rtAL AC~E~RY SFRtJ(~¢~R£S SUeD,V,S~ON <br /> <br />20 NALKING WOOD OR <br />LAKE 0fOrEGO 97035 <br />PHONE: 635-7918 <br /> <br />CEN1URY MgADONS <br /> <br />SI1E NUMBER: <br /> VALUAIiON: <br /> <br /> 13615 <br /> $1,300.00 <br />ZONE MAP <br /> <br />60 100 6000. SF NO NO <br /> <br />BUILDING <br /> <br />PEF~41r OR APPLiCAFiON NO: <br /> <br />CL)NIRAC1OR, NO+ '7~977 <br />LA MAIN CONS'f_ INC. <br />206 SE 4TH <br />rRO. JFDALE. OR~N 97060 <br />PHONE: 667-3790 <br /> <br /> 9033872 <br /> <br />ARC. HIIEC1/FJN~IN~ER, NO. <br /> <br /> ifE~ <br />BUiLDiNG FEE <br />PLAN REVIEW <br />BUILDING STAI~ SURCHARGE <br />ZONING SURCHARGE <br /> <br />I'O'TAL A~F,E~ED <br />PRE~'IOUS RECEIPTS <br />THiS RECEIPI <br /> <br />QUANI flY <br /> <br />AN~JUN ¥ <br /> $22.00 <br /> $14.30 <br /> <br />$38.50 <br /> $o.oo <br /> <br /> ~'k BALANCE DUE $0.00 <br /> PAYE~: LA fcC.[N C"ONST. INC. '"',,~\ 35719 <br /> R~CEIVED BY: [.~12 :;["~.._~,,~,~:;_.,.~ tYPE: CK ~ECK ~: 3329 <br /> <br />m flits i~ NOr A PE~1 r. rHzs APDLi~FiON ~8'r ~ fH~ A REV1~N P~E~ ~R~ file <br />DOLLYING NUS] DE ~PLEf'ED. IT iS ~"H~ RB~P~SIBiLIIY O~ 'fH~ APPL1CAN1 ]O ~RE ~HAI <br />AlL N~C~ARY INFO~fi~ H~ ~E~ P~ViDED_ <br /> <br />CI1Y JURISDICTION: BY <br /> <br />SEPI tG: BY DA'rE ......................... <br />RPB~IARKS: CA~RPORT ...... <br /> <br />HEiGHI: 14 IOIAL ~ Pi: 2~0 SIORIE$~ <br /> <br />PLAN.ACIION: <br /> <br />FORM#MC 15.56REV 4/90 OFFICE COPY <br /> <br /> <br />