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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 IqIGH 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 perfo rning work on a property r own or occupy, <br />( ) I am a regis erod bu der OR ( the authorized representative SIGNAfURE OF APPLICANT: <br /> Of a rogistered builder. <br /> <br /> 12/04/91 <br /> <br />ADDRESbL'~URORA S]'A:I'E A]RF%)RI' <br /> <br /> 14.357 KEIL RD NE <br /> AURORA <br /> OR <br />USE OF BUILDING. <br /> <br />CONSI RUCTION TYPE: <br />CONTRACT CITY; <br />r4AR I ON COUN'I'Y <br /> <br />NO <br /> <br />OCCUPANCY: COD,Y4ERC 1AL <br /> <br />NO OF RFDR00M$ <br /> <br /> ..... : .... -' ' ~..._~,,~__.r__.~_____.=~,,¢'"-~_ ....... -'"'/ $1TE NUI~ER: <br />LOT: BkOCK:~- ~ TOWNSHIP; RA N G'~ALUA'[ tO~ ' ZONE; <br /> <br />15053 <br />$3,000.~p: <br /> <br />WIOTH: DEPTH; AREA. 2 UNITS: <br /> <br />LOT' 1~ CORNER~ PA <br /> NO ,, NO <br /> <br />TYPE: BUILDING PEf, cJ~Ii'F OR APPLfCATION NO.- <br /> <br />CONTRACTOR, NO. <br />AURORA STATE A~RPOR'F <br />~41 INVES'rRENT PC~ <br />14357 KEIL RD NE LARRY RI'F <br />PHONE: 236-6000 <br /> <br /> iTEM <br />BUILDING FEE <br />PLAN REVIEW <br />~I'T'E PLAN REVIEW, BUILDING INSPECTION <br />SI'rE PLAN REVIEW, PUBLIC NORK~ <br />BUILDING 5'I'A'I'E SURCHA~E <br />ZONING ,,~JROHAK~E <br /> <br /> 9037196 <br />ARCHiTECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />QUANTITY <br /> <br />PAYEE: LARRY RiTC~EY/ PC~ AC(X.~N'F <br />RECEIVED BY: CL <br /> <br /> TOTAL ~ESSED FEES <br /> PREWiOUSR~CEiP'f'S <br /> THIS RECEIPT <br /> ALANCEmE <br /> <br />TYPE: CK CHECK <br /> <br /> $38.50 <br /> $25.03 <br /> <br /> $1.93 <br /> <br />$146.39 <br /> $0.00 <br /> $25.03 <br /> <br />39160 <br /> 1202 <br /> <br />* 'tHiS IS NOT A PER¢41'I'. THiS .APPLiCATiON Nus'r ¢J,DO 'THROUGH A RE'ClEW PR(XDE~,Jx'-5 ~HERE THE <br />FOLLOWING IviUs'I' BE COMPLETED. iT I.S THE RE~PONSiBILITY OF' THE APPLICANT TO ~RE ]HAT <br />ALL NEC~ARY INFORMATION HAS BEF:~ PROVIDED. <br /> <br />PLAN REVIEW: BY ............. ~...~ ........... DATE ~/'~ <br />PUBLIC ~R~: BY DATE CITY JURISDICTION: BY <br />SEPTIC: BY <br />REMARKS: L$"/4~ <br />BEIGFI'I: <br /> <br />MC ~ 6-56 REV, 4/~0 <br /> <br />OFFICE COPY <br /> <br /> <br />