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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 <br />CODE-A-PHONE 4::30 P,M - 800 AM <br /> <br /> th~s document <br /> <br />D&TE: 05/82/88 ~iMEt 1:45:19~ <br /> <br /> ~OOLSEY, 0U~WE <br /> <br />SIGNA'CURE OF APPLICANT <br /> <br /> 'fAX LOT CATEGORY <br /> RES I DEN T t <br /> <br /> CONSTRUCTION 'tYPE OCCUPANCY <br /> <br /> !457 MCCLELLAN RD SE CONYRAC? Ol't¥ U6B OCCUP^N'r LO,~D <br />AUMSV I LLE OR 97325 <br /> MARION COUNTY NO <br /> <br /> ~EST STAYTON LOTS 3~8 <br />SAME <br />PHONE: 749-1573 SITE NUMBER: C/"~4195~ <br /> VALUATION: ""~-,~ <br /> <br /> 8 12 9S 2~ AR 62 <br /> 150 2?5 NO i NO <br /> <br />TYPE: PLUNfglNG <br /> <br />CONTRACTOR. NO_ <br />WOOLSEY, DUANE <br />SAME <br /> <br />PEP. NiT OR APPLICATION NO: <br /> <br />PHONE¢ 749-1573 <br /> <br /> ITEM <br />MOBILE HOME S~NER AND HATER CONNECTION <br />FLEET SURCMARGE -ZONE 3 <br />PLUMBING STATE ,SURCHARGE <br /> <br />TOTiL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />OUANTITY AMOUNT <br /> 1 $25.00 <br /> $3.84 <br /> $175 <br /> <br />$30,09 <br /> $0_00 <br /> <br />BALANCE DUE $ ¢. 0u <br /> <br />PAYEE; RECEIPT NO: <br />RECEIVED 8Y: J8 TYPE: CHECK ~: <br /> <br />* THIS IS A VALID PERMIT · THIS PERMIT EXPIRES 180 DAYS FRO~ ITS ISSUE DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS. OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LANE AN~ MARION COUNTY BUILBING AND ZONING ORDINANCES, THIS PERMIT <br />SHALL BECOME NULL ANB VO~B. ' <br /> <br />REMARKE- MH S/N CON <br />30NALC E. NOOOLEY, MARION COUNTY BUILDING OFFICIAL / BY ........... _~;2~z~-_,7~.~¢.~'':) <br /> <br /> <br />