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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 />i am a registered builder Off; ) the authorized representative <br />Other. <br /> <br />I have read and agree to the terma stated on the reverse side <br />this document, <br /> <br /> ~ C~NYRAOT OI~Y; ~ U~B'. ; OOGU~NT LOAD'. <br />ASPEN DR -- <br /> <br /> SITE NUMBER: 94-81579 <br /> PHOI,iE: 375-82;:~4 VALUAT]',ON: $3,000.00 <br /> <br />W QT~4 IDEPTH AR~~ UN T~¢'') ¢ IR~ LOT: , CORER; U I <br />....................... ~ ....................... 2~ ............. A.~9~ ........ SF ' NO .............. NO <br /> <br />TYPE: BUILDING PERNZT OR APPLICATION <br /> <br /> ITEM <br />DUIt,BIHG FEE <br />PLAN REVIEW <br />BU[I,,DIN6 STATE SURCHARGE <br /> <br /> 9854428 <br />ARCH!IECT/ENGINEEk~ NO. <br /> <br />TOTAL, ASSESSED FEES <br />PREVIOUS RECEIPTS <br />f~].o RECE~F'T <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $38.50 <br /> $25.03 <br /> $1.93 <br /> <br />$65.46 <br /> $0,, 00 <br />$~. ,6 <br /> <br />BALANCE DUE $0.00 <br /> <br /> PAlE. E: Del flcCor~lt/~lf,,/_.. 56904 <br /> <br />* THiS iS NOT A PER~ZT. THIS'APPLiCATION MUST CO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MOaT BE COMPLETED., IT IS THE, RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL NECESSARY INFORNATION NAS BEEN PROVI~EB. <br /> <br />,. ,I l,t.C, lEI~, ....................... 7r .....DATE .......................... <br />CT'f'Y JURI'O~IC'¥':f'I N',: BY .............. I)AI'E ...................... <br />l ~'::;J"/~RK S ', CARPORT <br /> <br />HEIGHT: IB SETBACKS: FR 10 <br />TOTAL SQ T. ~00 LS / <br />STORIES: t RS'"6 <br /> PLAN. AC, T ~:ON: RR 10 <br /> EMt::R~Y PA'FH: SF .... <br /> <br />=OhM # MD ~ 5.§~ n~. 4~0 OFFICE COPY <br /> <br /> <br />