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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 />Other <br /> <br /> SAN'I',[AN <br /> <br /> :1,1J73 N'[LL CREEK RI) <br />AUNSVILL. E OR 97325 <br /> <br />OI-F.[f.E,~ ~ahlK, AND 1'(0 P..,..',.,I. OhfAL, ~UILDIH(-,;$ <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br /> ~6~30000 <br /> <br />CONSTRUCTION TYPE <br /> <br />CATEGORY: <br /> CONi'tE_'R C I AL <br /> <br />OCCUPANCY: <br /> ? <br /> <br />SaNE <br /> <br />F:'HONE: 769,.,,7744 <br /> <br />SITE NUMBER: 74-01217 <br />VALUATION." $5,000.00 <br /> <br />SECTION: TOWNSHIP; <br /> RANGE ~ ZONE: MAP' <br /> <br /> ......... ............. ............... '..._.lt/.¢: ..... <br /> AREA UNITS RR~% LOT. ! CO R ~E(~'. .... <br /> <br />TYPE: <br /> <br />C0i~t'J"R~CTOR~ 1,10. 38238 <br />Daniel L Cal"v¢<;r <br />117;73 t4J, i:l. Creek Rd <br />Au~,~sville~ 97;25.-eeee <br />PHONE= 7~9-,.7744 <br /> <br /> ITEN <br />BUILDING FEE <br />Pl..AN REV~E~ <br /> <br />BUILDING PERNiT OR APPLICATION NO: <br /> <br /> 90~3816 <br />ARCHITECT/EN~INEER~ NO., <br /> <br />PHONE: <br /> <br />QUANTI'FY <br /> <br /> AMOUNT <br /> $50,,50 <br /> $32,. ,, <br /> B~JILDING STATE SURCHARGE ~ $ ....... <br /> ZONIN6/--~SURCHARGE. ~- ~ Y~ ,~ ~2.53 <br /> <br /> ~ PF(EVIOUG RECtE~PTS ~. <br /> THIS RECEIPT !~88,, 39 <br /> · ~ALANCE ,DUE sB. e~ <br /> PAYEE: S~I4T:[hN NDBZLE HONES 5&287 <br /> RECEIVED ~Y;~ CL TYPE: CK CHECK ~: 846~ <br /> <br />~ THIS IS HOT A PERH~T. T~lS APPL/CATIOH, HU~T ~O THROUGH A REVIEW PROCESS WHERE THE <br />FOI.,LOWIN~ HUST BE COHPLETE9. Il IS THE RESPONSIBIEITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY [HFORHATIOH HAS BEEN PROVIDED. <br /> <br />PLAN REVIEW; BY DATE <br />ZO;,ilNi;.,,~ Iw /,~-. ....................... DATE"~,. ¢.?, g~5_ <br /> <br />£;iTY ,JUR].>D,'I ~i ION. BY DATE, .............. <br />,"J:,'~AHk! ,': SANTIAN IlL1Hc~ (OFFICE~NFG) I~U~SS <br /> <br />HE] G- l'~ <br /> <br />PLAFL ACTION: <br />ENERGY PATh. <br /> <br />AU'i"H: WILL <br /> <br />SETBACKS: FR.~" <br /> I..!3 ............. <br /> R~ ...... <br /> <br /> <br />