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MARION COUNTY BUILDING INSPECTION <br />SENATOR B~i, DG. NO. 225 <br />22OiHIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M. <br /> <br />I am performing work on a property I own or occupy. <br />I am a register&d builder OR ( ) the authorized representative <br />ol a registered builder. <br />The work will be performed by a registered builder, <br />Other <br />I have read and agree to the terms stated on the reverse side of <br />this document, <br /> <br />SIGNATURE OF APPLIGAN¥: <br /> DATE~ <br /> <br />01/22/90 TIME: <br />BIELENBERG, TIM <br /> <br /> TAX LOT: <br /> <br /> 61964-000 <br />' ~O'4~TRSCTION TYP~: <br /> <br /> 7925 HILTON LANE SE <br />TURNER OR 9?392 <br />USe OF BUIL'D~N~: ........... <br /> <br />11314 MILL CK RD <br />AUMSVILLE, ORE 97325 <br />PHONE: 769-2090 <br /> <br />WIDTH: DERTH; <br /> <br /> SITE NUll~ER: 9138 <br /> VALUATION ~ <br /> ; TowN,HiP: RANGE; ZONE: <br /> <br /> 26 9S IRREG LO~W CORNEF~F]J <br />^~EA: U~T~: <br /> 60* : AC NO : YES <br /> <br />CATEGORY; <br /> RESIDENTIAL <br />OCCUPANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />NO DF 8£0R00MS <br /> <br />MAP: <br /> <br />TYPE; PLUNSING <br /> <br />CONTRACTOR, NO. <br />BIELENBERG, TIM <br /> 11314 MILL CK RD <br />AUNSVILLE, ORE 97325 <br />PHONE: 769-2090 <br /> <br />PERMIT OR APPLICATION NO; 21072 <br /> <br /> ITEM <br />SE~ER LINES, 1ST 100 FEET <br />MOBILE HONE SENERAND WATER CONNECTION <br />FLEET ECJRCHARGE -ZONE 2 <br />PLUM~ING STATE E~JRCHARGE <br /> <br />PAYEE: <br />RECEIVED BY: PR <br /> <br />QUANTITY AMOUNT <br />1 $30.00 <br />1 $25.00 <br /> $2.56 <br /> $2.75 <br /> <br />TOTALP,,.~.SESSED FEE,~ <br />PREVIClJS RECEIPTS <br />THIS RECEIPT <br /> <br />¢60,31 <br /> 60.31 <br /> $o.oo <br /> <br />BALANCE DUE $0.00 <br /> <br /> RECEZPT NOs <br />TYPE: CHECK <br /> <br /> THIS IS A VALID PER~IT :* THIS PERMIT EXPIEES 180 DAY~ FE~ IT5 ISSUE DATE. IF <br />CSi~-'TRUCTION CEASES FOR A PERIOD OF 180 DAYS* OR IF ~tlCTION FAILS TO ~ ALL <br />SHR~UAi.Rf~qiJiRE]~ENTS OF STATE [ANS ~ND ~4ARION C~IJNTY 'BUILDING ~ND ZONING ORDINANCES, THIS PIB~NIT <br /> L 8ECOI~E NULL AND VOID. <br /> <br /> CON, SL <br /> <br /> [~ALD E~ WOODLEY, f,~RION COUNTY ~U~LDI'NG oFPIC~AL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />