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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 />am perform)ng work on a pro,erty I own er ocoury, . <br />am 8 registered builder O~ ( ) the ~uthodzed representa ~ve S GNATURE 0¢ AP LtCANT <br /> <br />DATE= 08/10/92 TIME: 10:56:14 <br />LRKE~OOD HOHEO~NERS, ~NC. 72~0-006 ' COHHERC~RL <br /> <br /> LAKEWOOD DR NE: ~8~T ~TX~,,,;; q~ ',dCbUPANT LOAO: <br /> AU.O A <br /> <br /> PUBLIC ~ORKS ~NO UTILITIES BUILDINGS <br /> <br /> L~KE~OOO EST~ <br /> <br /> VRLU~TION: <br /> PHONE: 678-5746 ' $9,000.00 <br /> <br /> 2~ 43 : l~ RS , 5 <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. <br />LAKEWOOD MOHEOWNERS, INC. <br /> <br /> 904182~ <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: 678-5746 PHONE: <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEW <br />BUILOING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br /> /~LANCE QUE <br />PAYEE: OANEAL CONSTRUCTION <br />RECEIVED BY: DM2 ...... d ............. ~_L ..... <br /> <br />QUANTITY AMOUNT <br /> $74.50 <br /> $48.45 <br /> $3.75 <br /> $3.75 <br /> <br />$130.39 <br /> $0.00 <br />$130.39 <br /> <br />$0.00 <br /> <br /> 45868 <br />TYPE: OK CHECK ~: 7866 <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICAHT TO ASSURE THAT <br />LL NECESSARY INFORMATION HAS BEEN PROVIDED. <br /> <br />PLAN REVIE~ <br />ZONING: <br /> OATE-- <br />SEPTIC: BY~7)L_~ ....................... <br />CITY JURISDICTION: BY ........ DATE ......... <br /> <br />HEIGHT: 32 <br />TOTAL $QFT: <br />STORIES: <br />PLAN.ACTION: <br />ENERGY PATH: <br /> <br />SETBACKS: FR_,,~,/,./ <br /> R¢_~,,~_~.~ <br /> SP <br /> <br />REMARKS: BLOG FOR WELL WATER TREATMENT PLANT <br /> <br /> OFFICE COPY <br />FORM # MG 15-5~ REV, 4/90 <br /> <br /> <br />