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MARION COUNTY BUfLDING INSPECTION <br />SENATOR BLDG,, NQ 225 <br />220 HIGH STREET NE <br /> BALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4::30 PM, - 8::00 A,M <br /> <br />04/!0/89 TINE- 9:28;33a <br /> <br />WOOLSEY, DUANE <br /> <br />RESIDENTIAL <br /> <br />OCCUPANCY <br /> <br /> 11457 ~CcLKI.LAN RD SE <br />AU~SVILLE OR 9?325 <br /> <br /> CONTRACT crYY UGB <br />NARION COUNTY NO <br /> <br />OCCUPANT LOAD <br /> <br /> NO OF gE~)ROOMS <br /> <br />PHONE: 749-1573 <br /> <br />2?5 <br /> <br />NEST STAYTON LOTS 3-8 <br /> <br /> SITE NUMBER: 4195 <br /> VALUATION: <br /> <br />12 9S 2W AR <br /> NO NO <br /> <br />TYPE: PLUMBING <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR. NO_ <br />~OOLSEY, DUANE <br />SAME <br /> <br />PHONE: 749-1573 <br /> <br /> ITEM <br />MOBILE HONE SEWER AND WATER CONNECTION <br />PLEET SURCHARGE -ZONE 3 <br />PLUF~ING STATE SURCHARGE <br /> <br />14937 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS REC~P,~ <br />THIS RECEIPT <br /> <br />QUANTITY AMQJNT <br /> $25-00 <br /> <br />$30.09 <br />$30.09 <br /> $0_00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: RECEIPT NO= <br /> <br />RECEIVED DY: pn .... TYPE¢ CHECK ¢; <br /> <br />$ T,4IS IS A VALID PERMIT $ THIS PE~4IT EXPI~ 180 DAYS FRO~ ITS I~E ~TE_ <br />~CT[~ CE~ES FO~ A PER~OD OF 180 ~. OR IF ~T~CTI~ FA[~ TO MEET <br /> <br />~ALL BEdE NULL ~D VOID. <br /> <br />R~4ARK$: CONN R~7368 <br /> <br />0ONALD E. NOOOLEY, ~ARION COUNTY BUILDING OFFICIAL / BY <br /> <br />FORM # MC 1556 REV 11'8~ OFFICE COPY <br /> <br /> <br />