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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 325 <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 perfc, rming work on a property I own or occupy <br />I am a (oBistered buflder OR the authorized representative <br /> of a registered builder. <br />The work will be performed by a registered builder. <br />Other <br /> <br />I hove read and agree to the terms stated on the reverse side of <br /> <br />SIGNATURE OF APPLICANT: <br /> DATE: <br /> <br />, ~Su~;,~4S'c~ T I A L <br /> <br /> ' CONTRACT CITY: i uGg; ;~PANT LOAD: <br /> 403 DUR~IN DR -- 31 , ~ r <br />AUi~EV.ILLE · OJqL ~.7. ~2 f5 .......iAUMSVILLE i NO <br /> <br /> S~RUCTORE ; summws,o~; <br /> <br /> M~EE'-C'REEK 'ESTATES <br />2839 KENNEDY 6TR NE <br />KE:[ZER~ OR 9'73~ SITE NUHBER~ 94-~2~95 <br />PHONE: ~B-8588 VALUATION: <br /> <br />TYPE: HANUFACTURED STRUCTURE PERHIT ORAPPLICATIBH HO= <br />CONTRACTOR, NO,, 98948 <br />Capitol Awning <br />518 Vallexwood' Or SE <br />Salem~ <br />PHONE: 363-171;[ , <br /> <br /> I'rEM <br />NANOFACTUREB STRUCTURE PLACE~EHT/OONNECTION <br />MANUFACTURE~ STRUCIURE STATE ~'EE:~ <br />HANOFACTURE~ STRUCTURE STATE SURCHARGE <br /> <br /> TOTAE ASSESSE~FEES <br /> PRE~IOUS RECEIPTS <br /> THIS RECEIPT <br /> <br /> · : BALANCE:BUE <br /> <br />QUANTITY AMOUNT <br /> $182.0¢ <br /> $20.08 <br /> $9.18 <br /> <br />$211.10 <br /> $0.00 <br />$211.10 <br /> <br />$0.00 <br /> <br />PAYEE: Capitol Aumir~g INVOICE 5838? <br />RECEIVED BY: pm .... ~....................................... TYPE: IN CNEOK ~: 0 <br />* THIS IS HOT A PERNIT. THIS APPLICATION NUST 60 THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST BE COHPLETE~. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSORE <br />THAT ALL HECESSARY INFORMATION HAS BEEH PROVIDED. <br /> <br />ZONING: BY <br />SEPTIC: BYZZZZ~i;_-_--ZZZZ <br />CITY J,URISJQICTiON. BY <br />REMAR~.~S: M8~ CARPORT .......... ' ........ <br /> <br />SETBACKS: <br /> <br />FR 10 <br />LS"15 <br />RS'-'15 <br />HR-lO <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 R~V. 4/90 <br /> <br /> <br />