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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 />of a registered builder. <br /> <br />Other. <br /> <br />have read and agree to the terms stated on the reverse Side Of <br /> <br /> DA're: <br />' OWNER: <br /> <br />TIME; 9:38:59 <br /> <br />TAX LOT CATEGORY <br />CONSTRUCTION TYPE. OCCUPANCY. <br /> <br />RES1 DENT iAL <br /> <br /> q `i684 LARK (:,'OUR <br />AURORA OR 9'7002 <br /> <br />USE OF BUILDING; <br /> <br />CONTRACT CITY UGB' OCCUPANT LOAD <br /> <br />NARION ~r,A.INIY~ NO. . . <br /> NO. OF BEDROOMS <br /> <br />' MA~L~NG ADDRESs: --"' SUBDIVISION <br /> <br />20 WALKING WOOf,,,) {}R <br />LAKE O~NEGC. OR <br />PHONE: 836-7918 <br /> <br />LOT: BLOCK SECTION TOWNBH rP <br /> <br /> 85 85 5525. BP' <br /> <br /> TYPE: PLUIVlBJ. Nf3 PERtVIi'[' OR APPLICATION NO: <br /> <br />C©N'T'RAC'T'OR NO. ?3977 <br /> LAIV~iN CONS RUC iCH <br />208 SE 4'T'H <br />f'ROU'f'DALE, 9?060-0000 <br />PHONE: 760-?'F36 <br /> <br />CENTURY MEAOO~ NO 4 <br /> <br /> SiTE NUMBER: 92-01584 <br /> VALUAT ION: <br />RANGE; ZONE MAP. <br /> <br />IRREG. LOT CORNER: <br /> NO NO <br /> <br />39541 <br /> <br /> J'f'E~ QUAN'T'ZTY A~OUN'T <br />NA'f'ER LINE~, 'l~'f' ]0O FEET I $20-00 <br />SENER LINE~, lS'l' 100 FEET <br />PLUF4'8[NG STATE SURCHARGE $2.50 <br /> <br />TOTAL AS~E~EB P'EE~ <br />PREVIOUS RECEIPTS <br />'THIS RECEZPT <br /> <br />$52_50 <br />$52.50 <br /> <br /> BALANCE DUE <br /> <br />PAYEE: RECEIPT NO: <br />RECEIVED BY: DM2 TYPE: CHECK ~; 0 <br /> <br />$O.0O <br /> <br />$ THi~ IS A VALID PER~llT ~ THiS PEr,lIT EXPIRES 180 DAYS FROM ITS ISSUE DATE. IF <br />CONSTRUCTION CEA~E~ FOR A PERIOD OD 180 DAY~, OR iF CONSTRUCTION FAILS. TO ~EET ALL <br />REQUiREmENTS OF STATE ~ AND I~ARION COUNTY BUILDING AND ZONING ORDINANCES. THIS PERf~lIl' <br />,,~¢-IALL BECO~IE NULL,AND VOID. <br /> <br />REHI,ARKS¢ NL, ~L <br /> <br />D©NALD E. NOODLEY, ~AR[ON COUNTY BLiLDiNG O?P'ICIAL / 8Y <br /> <br /> OFFICE COPY <br />FORM # MC 15-/~6 REV. 4/90 <br /> <br /> <br />