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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 /> ©thor .......... <br /> <br />DATE: 04/19/91 'riflE: 10:25:02 <br /> H,[ L!.~, HAROLD <br /> <br />S)GNATURE OF APPLICANT: <br /> DATE'. <br /> <br /> TAX LOT: <br /> <br /> CONSTRUCTION TYPE: <br /> <br /> 120 PATTON RD <br />DE rROi 1' OR <br /> <br />:CATEGORY: <br /> RF~51DENl'IAL <br /> <br />MAILING ADDRESS: <br /> <br /> BOX 46~ <br />BE'rROI'F, OR 9'1342 <br /> <br />LOT: BLOCK: <br /> <br />OCCUPANCY: <br /> <br />97342 , CONTRACT CITY; U~B: <br /> DETROI 1' NO <br /> <br />, SECTION: : TOWNSHIP: <br /> <br />SUBDIVISION: <br /> <br /> SITE NUIV~ER: 9328 <br /> VALUATJCN~ <br /> <br />MAP: <br /> <br />TYPE** MECHANICAL PEF~Ii'F OR APPLiCA'rJ[ON NO: <br /> <br />31662 <br /> <br />CONTRACTOR, NO. <br />HILLS, HAROLD <br />P,O. 8OX 483 <br />DETROIT, OR 97342 <br />PHONE.· 85~-3441 <br /> <br /> 1 'rE~ <br />OC~1ES'FiC [ef3OD 8'rove <br />MEE,~ANI[~a~L BASE FEE <br />ME(.~.N~iCAL STATE SUk%.~ARGE <br /> <br />TOTAL A,.~ED FEES <br />:PREViISU~ RECEIPTS <br />THiS RECEIPT <br /> <br />PAYEE: HILLS, HAROLD iNVOICE NO: <br />RECEIVED BY: PR TYPE: IN CHECK <br /> <br />QUANTITY AMOUN'I' <br /> $?.50 <br /> $1o.oo <br /> $0+88 <br /> <br /> $18+38 <br /> $o.o0 <br /> $18.38 <br /> <br /> $0.OO <br /> <br /> 33435 <br /> 0 <br /> <br /> :~ THI~5 IS A VALID PEJ~RIT v~ THIS I:~Ei~tIT <br />~T~Z~ C~ ~ A ~I~ ~ 1.80 ~. OR IF'~T~I~ FAI~ ~ ~T ALL <br />~I~ OF ~TATE ~ ~D ~l~ <br /> <br />RP3'AARK~: 1~'3ODS'FOVE ~q D <br />DONALD E. ~DLEY, rd, ARiON COUNTY BUiLDiNG OFFiCiAL / BY ............................................................................................. ~'~ <br /> <br />FORM # MC ~-~e ~Ev. 4/~o OFFICE COPY <br /> <br /> <br />