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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 8:00- 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> lam&reglsteredbuilderOR( )theauthorizedrepresentabve <br /> <br /> The work WHI be performed by a registered builder, <br /> Other <br /> <br /> DATE: 06/29/92 TIME: 15:48:19 <br /> KLEIN~ LARRY r ~ RESIDENTIAL <br /> ~ : bCOUPANCY: <br /> SITUS ADDRESS; ; CONSTRUCTION TYP~; <br /> <br /> 9804 HILL CREEK RD SE <br /> AUHSVILLE OR 97~25 <br /> <br />~usE °~ ~uILD~NuF~CTUEED STRUCTURE 2 <br /> <br /> FLOODPL~ Z N <br /> <br /> i SZTE NUMBER: ~2~02405 <br /> PHONE: 749-2405 ~ V~LU~TZON: <br /> <br /> ~ : ~1 8S ; 1W ; EFU i 48 <br /> <br />PERMIT OR APPLICATION NO: 9040941 <br /> <br />TYPE: MANUFACTURED STRUCTURE <br />CONTRACTOR, NO. <br />KLEIN. LARRY <br /> <br />PHONE: 749-2405 <br /> <br /> ITEM <br />MANUFACTURED STRUCTURE ZONING SURCHARGE <br />MANUFACTURED STRUCTURE STORAGE PERMIT <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS: RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $15.00 <br /> $25.00 <br /> <br />$40.00 <br /> $o.oo <br />$4o.oo <br /> <br /> ~ /S~LANOE DUE $0.00 <br />PAYEE: KLEIN, L~,8~ .~ .-,,-~.-.. /~ ' RECEIPT 42972 <br />RECEIVED BY: MBB~f~J-~ TYPE~ CK CHECK f/- 947 <br />* THIS IS NOT A PERMIT. THIS APPLI,CATION SO 'rHROUCH A REVIE# PROCESS #HERE THE <br />FOLLONING HUST BE COMPLETED;-; IT IS THE RESPONSIBiLiTY OF THE APPLICANT TO ASSURE <br />THAT ALL NECESSARY INFOR?ATION HAS BEEN= PROV'rD~D.,, <br /> <br />PLANNING ACTION: ~,.... <br /> PLAN REVIEW: BY ~:.'.'.'.'.'.'.'.'~/%~ ~ DATE' <br /> SEPTIC: BY ............. SS DATE <br /> CITY JURISDICTION: BY DATE <br /> REMARKS: FOR MS <br /> <br />SETBACKS: <br /> <br /> OFFICE COPY <br />FORM # MO 15-56 REV, 4/90 <br /> <br /> <br />