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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 <br />24 HOUR CODE-A-PHONE: 588-'7904 <br /> <br /> ol a registered b~iJder. <br /> <br />) Other <br /> <br />SIGNATURE OF APPLICAN'T: <br /> <br /> DATE: <br /> <br />OwN~TE: ]2//I 7/9] TIME: <br /> SAN'f' iAM HONES <br /> <br />TAX LOT: CATEGORY: <br /> <br /> 5 ~ F06~O0 <br />CONSTRUCTION ;~YPE: OCCUPANCY: <br /> <br />RESiO~'I'IAL <br /> <br /> 320 g¥ERGREEN DR ,37 CONTRACT CITY: 5U~: : OCCUPANT LO~V~'71 <br /> AUMSV 1LLE OR 97325 <br />USE OF BUILDING: AU~VILLg NO NO 0F BEDROOMS <br /> <br />~AILING A~Dn~SS: <br /> <br />EVERGREEN ~ILE PARK <br /> <br /> PHONE: St'rE NUMBER: 14'704 <br /> VALUATION*. <br />LOT'. eL0~K~ SEC~i0N: TOWNSHIP: RANGE: ZONE: MAp: <br /> <br />w~6~: 37 25 8S 2N <br /> DEPTH; AREA: UNITS: ~RR~G. t,OT: OO~NER: <br /> <br /> 55 85 46~Z5 ~' ' NO; NO <br /> <br />TYPE: BUILDZNG PER~i'[' OR APPLICATION NO: 9037411 <br /> <br />CONI'RACTOR, NO. <br />Oanfe] L Carver <br />11373 NI"I'I Creek Rd <br />Au~¥i]]e, <br />PHONE: 769-?'744 <br /> <br />ARCHtl'EC'I'/ENGINEER, NO. <br />PHONE: <br /> <br /> ITEM <br />BUiLDiNG FE~ <br />PLAN REVIEW <br />BULLOING S'('AI'E ~JRCHARGE <br /> <br />28.93 <br />$2_23 <br /> <br />'f'OTAL A~.~E~ED P'EES <br />PREVIOUS RECeiPTS <br />THIS RECEIPT <br /> <br />$75-86 <br /> <br />$75.66 <br /> <br />BALANCE DUE <br /> <br />PAYEE: ~nie"l L <br />RECEIVED BY: F~3 TYPE: IN CHECK ~.+ O <br /> <br />~ 'l'Hi¢ iS NOT A PER~I']'. 'TH~S APPLICATION ~US'I' GO THROUGH A REVIEW PROCESS WHERE THE <br /> <br />FOLLOWING MU~'f' BE COMPLE'FEO. <br />ALL NECE~ARY iNFOP74ATION HA~ BEEN PROVIDED. <br /> <br />J'r ~ 'f'BE R~PONSI~iLi'FY OF' THE APPLICANT f'O ASSURE: f'HA'f <br /> <br />SEPTIC: BY ............................................. DATE ......................................... <br /> <br />ZONING: BY DATE ................................. SETBACKS= F'R._.]0 L5....10 <br />RFJ~IARKS: CARPORT ............ <br /> <br />HEIGHI': 1'1 'T'O]'AL SQ F"T: 312 S'T'ORIE~ <br /> <br />CiTY JURiSDiC'T'1C~: BY ................... DA'T'~ ......... <br /> <br /> RS...10 RR,,,10 ¢P ................. <br /> <br /> PLAN.AC'liON; <br /> <br /> OFFICE COPY <br />FORM ~ MC 15-58 ~EV. 4/90 <br /> <br /> <br />