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MARION COUNTY BUILDING iNSPECTION <br />SENATOR BLOC, NO. 225 <br />220 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />( ) <br />( ) <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am performing work on a property I own or occupy. <br /> I am a registered builder OR the authorized representative S GNATURE OF APPLICANT' ' <br /> of a registered buitder. <br /> The work will be pedormed by a registered builder. <br /> Other <br /> <br /> DATE: 10/15/92 TIME: 16:08:59 <br />OWN ER~ TAX LOT CATEGORY <br /> REESER, LARRY RESIDENI'IAL <br /> <br /> ADDR~$~i ............ C'G N ~¥'~tJ~TJ~ N 'TYPE OCCUPANCY <br /> 5 -N R~5 <br /> 7750 AUHSVILLE IWY SE <br /> AUHSVILLE OR 97325 ~q~ct~ c~yEij N T y u~(~, OCCU~^.T bo^[ <br /> <br />OTBER NON-RE$IOENTIAL 8UILOING8 <br /> <br />SAHE <br /> <br />PNONE: <br /> <br />SITE NUMBER: <br />VALUATION: <br /> <br />92-0~689 <br /> $9.000.00 <br /> <br />LOTi <br /> <br />WIDTH~ <br /> AC <br /> <br /> TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br /> CONTRACTOR, NO,, 86656 . ~ <br /> ROSS HILLER ~~,~.k~__ ~ () [~8~ <br /> 214 CEDAR TERRACE CTf~~_ ~ <br /> STAYTON 9758~ <br /> P~ONE: 769-5606 <br /> <br /> ITEN <br /> BUILDING FEE <br /> PLAN REVIEW <br /> BUILOIN6 STATE SURCHARGE <br /> ZONING SURCHARGE <br /> <br />' 23 8S 2N P~ <br /> NO NO <br /> <br /> 9045250 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAl. ASSESSED FEES <br />PRE¥IOUS RECEIPTS <br />THIS RECEIPT <br /> <br />MAP <br /> <br /> I4 <br /> <br />QUANTITY <br /> <br />AHOUNT <br /> $74.50 <br /> $48.43 <br /> $3.73 <br /> $3.73 <br /> <br />$130.39 <br /> $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAYEE: ROSS HILLER t~ ~J~ 45531 <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIE~ PROCESS WHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICRRT TO ASSURE THaT <br />LL NECESSARY INFORMRTION HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW: BY,,,.~_,~_~,~, DATE ~3/~/'~.~_!f_ HEIGHT: 14 <br />ZONING: BY .... ~ -- DATE---~-~' TOTAL SQFT: <br /> <br /> PLAN.~CTION: <br />CITY JURISDICTION: BY ........... DATE ......... ENERGY PATH: <br /> <br />REHARK~: SHOP <br /> <br />720 <br /> <br />SETBACKS.- FR-- <br /> SP ....... <br /> <br /> OFFICE COPY <br />FORM # MC ~5-56 REV. 4/90 <br /> <br /> <br />