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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />Other <br /> <br />I have read and Agree to the terms stated on the reverse side of <br /> <br /> DATE: !0/21/92 ~IHE: 15:52111 <br /> GREEN ~ JOE <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> AURORA OR 97002 <br /> <br />'~OF~i'~DIN~': <br /> RESIDENTIAL ACCESSORY STRUCTURES <br /> <br /> CENTURY HEADOWS ~4 <br /> PO BOX 759 <br /> PORTLANO 97207 SITE NUMBER: 92-0~73~ <br /> PHON~: 685~9685 V&LUATION: <br /> <br />RESIDENTIAL <br /> <br />60 : ilO ~ ; YES : NO <br /> <br />TYPE: BUILDING <br /> <br />PERMIT OR ~PPLICATION NO: <br /> <br />CONTRACTOR, NO, 73977 <br /> LANAIN CONSTRUCTION <br />206 SE 4TH <br />TROUTDALE, 97060~0000 <br />PHONE: 760~7736 <br /> <br /> 9043352 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE= <br /> <br /> ITEM <br />BUILOING FEE <br />PLAN REVIEW <br />BUILOING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $20.50 <br /> <br /> $1.03 <br /> $1.03 <br /> <br />$55,89 <br /> $0.00 <br />$55.89 <br /> <br />$0.00 <br /> <br />2OO <br /> <br />LS <br />SP <br /> <br />PLAN REVIEW: BY _~...~_ OATE~ H~IGHT. 9 <br />ZONING: BY ...~_~ .... DATE ..~ .[~_ TOTAL SO FT: <br /> <br /> PLAN.ACTION: <br />CITY 3URISDICTJON~ BY .......... O~TE ...............ENERGY PATH: <br />.EHARKS: CA.PORT fol.& <br /> <br />SETBACKS: FR_L~. <br /> <br /> PAYEE: JOE GREEN ~ 45440 <br /> RECEIVED BY: DM2 ...................... ~ .......... TYPE: CK CHECK ~: 1132 <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST GO THROUGH A REVIE# PROCESS ~HERE THE <br />FOLLOWIN8 MUST BE CO~PLETEO. IT IS THE RESPONSIBiLiTY OF THE APPLICANT TO ASSURE THAT <br />LL NECESSRRY ~NFORMRTION HRS BEEN PROVIDED. <br /> <br /> <br />