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MARION COUNTY BUILDING iNSPECTION <br />SENATOR SLDG. N~. 225 <br />220 HIGH S,.TREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588~5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I I am performing work on a property I own or occupy, <br /> I am a registered budder OR ( ) the aLJthorized representative S)GNATURE OF APPUCANT: <br /> of a registered bddder, <br /> } The work will be performed by a registered builder, <br /> ) Other <br /> ) [ have road and agree to the terms stated on the reverse side of DATE; <br /> this document. <br /> DATE: :10/07/9~ TINE: 7:45:40 <br />'OWNER'. SANTIAN HO~ES ~ LOT; <br /> <br />S TgS ADDRESS <br /> <br /> 315 ASPEN BE <br /> AUHSVILLE <br /> <br /> O~RUOTIO N TYPE <br />OR ~732§ <br /> <br />USE of BU,L~,~¢iDENT~L ~C'SE~'S'~¥ "Sf~UCTU~E~ .......................... <br /> <br /> $UBD1VI ION'. <br />MAIl. lNG ACORSS$; ~LL CREEK ESTATES <br /> <br />i~c~E-~°I~ENT I AL <br /> <br /> OCCUPANCY: <br /> <br /> :NO. O~ B£DRO0~$ <br /> <br />AGENT: CRAIG LUCAS <br />PHONE: 769-7744 <br /> <br />..... s~TE-'RUNSER: <br /> VALUATION: <br /> <br />93-83478 <br /> $~000~g0 <br /> <br />'LOT. BLOCK: ¢~TION TOWNSHtP; RANGE ZONE: MAP: <br />~V~I'[~TH;' 162 [DEI:~H'. 60 AREA 9720. UNITS~F *PI~' LOT; CORN~ <br /> <br />TYPE: SUILSIN6 PERHIT DR APPLICATION HO: <br />CONTRAC~OR~ NO. 38238 -~'-~ <br />Daniel L\ O~¢rver <br />11~7~ M~l, Creek Rd <br /> <br />PHO~ 7~*-7744 <br /> ITEN <br />EUIL~N~ FEE <br />PLAN REVIEW <br />BUILBING STATE SURCHARGE <br /> <br />PAYEE: Daniel L Carver <br /> <br />ARCHITECT/ENGINEER~ NO, <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />BALANCE DUE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $38.50 <br /> <br /> $0.00 <br />$65.46 <br /> <br />$0.00 <br /> <br />52879 <br /> <br /> RECEIVED BY: DM2 ....................... = ........... TYPE: IN CHECK ¢: 0 <br /> <br />g THIS IS NOT A PERHiY. THIS APPLICATION HUST gO THROUGH A REVIE~ PROCESS #HERE THE <br />FOLLOWING MUST SE COMPLETES. IT IS THE RESPONSISILITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORMATION HAS SEEN PROVIDED. <br /> <br />PLAN REVIEW: BY BATE <br />ZONING: BY .......... DATE <br /> <br />CITY JURISDICTION: BY ......... DATE ......... <br />REMARKS: CARPORT <br /> <br />HEIGHT: 10 SETBACKS: FR 11 <br />TOTAL Sg FT: 300 LS"le <br />STORIES: i RS"'IO <br />PLAN. ACTION: PR-lO <br />ENERCY PATH: SP': ...... <br /> <br />FORM # MC 15.56 REV, 4/90 <br /> <br />OFFICE COPY <br /> <br /> <br />