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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG,, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 973o1 <br /> <br /> PHONE: 588-5147 B:00 * 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I sm performing work on ~, Oroperty I own or occupy <br />~ sm a cegisIered DuIIder OR ( ) the authorized representaPve <br /> <br />ow,~l'E= 0t/28/92 ' TIME=- ~:-33-r53 <br /> <br /> ALLEY, ~DE & LADY RO~ERTA <br />SITUS ADDRESS:: <br /> <br />"TAX L61' <br /> <br />:: OON~TF~UCTION TYPE:: <br /> <br />RES I D~NI' ~ <br /> <br /> 150 N BUTTE ~F <br />OEIROi1 OR 9?342 <br /> <br /> 7210 RiDGE, WAY RO <br /> E~IERI DAN, OR <br /> PHONE: 843-2622 <br /> <br />WIPTN ?/8 mDEPTN ~ ~ ' ARE~ 1 'UNIT5 <br /> 100, 100: 10000- <br /> <br />. . <br /> <br /> g['~"E NU~:~ER: 92-00518 <br /> VALUA::r leal: <br /> <br />10 ' I~E~;£OT 5E ~OR-NER <br />SF NO : NO <br /> <br />MAP' <br /> <br />I"YPE: ON-St'rE <br /> <br />PERNiT OR APPLiCa~,TiON NO: <br /> <br />CONTRACTOR, NO. <br />ALLEY. CUDE ~ LADY RC~ER1A <br />7210 RIDGENAY RD <br />~.iERID.~U',I, OR <br />~E: 842-2622 <br /> <br />g0~8082 <br /> <br />~TER SUPPLY: OH <br />TE~;T HOL~ READY: <br />SITE EVALUATION NUMBER= <br />~IST1NG T~K SIZE: <br />~tST~NG D~N F~ELO L~N~ <br />S~PTiC I'~K ~MPED: <br /> <br /> ....... TTE~ ..... \S~ -- C]U~Ti1Y AMOUN ~ <br /> AL FERATION ~'~(7 1 $150.00 <br /> <br /> THIS ~EIPT $150-00 <br /> <br /> PAYEE: ALLE~, ~OE ~ ~ ~ERTA' INVOICE NO: <br /> RECEIVe0 ~Y~ c3 TYPE: iN ~ECN ~: 0 <br /> <br /> SEE ATTA~ ~N~T ~ ~I~T~ OF ~I'F~ S~GE ~T~. <br /> <br /> * THI~ IS NOT A ~IT. THI~ ~I~Ti~, ~T ~ ~ A ~l~ ~ <br />~L~IN~ ~T BE ~PL~. ET iS ~E ~JBI~I~ ~ THE A~Li~T TO ~ THAT <br /> <br />REMARKS: ALI'ERAi ION <br /> <br />CITY JURiSDICTiON: BY ........................ DATE ............ <br /> <br />OFFICE COPY <br /> <br /> <br />