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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE * Room 132 · Salem, Oregon 97301-3670 <br />Office Hour.: 8:00-4:30 · Phone: (503) 588-~i147 · 24-HR Inepmctlon Line: (503) 37.~-4427 <br /> <br />DATE/I'~HE <br />TYPF <br />rJCCIJPAHCY <br /> <br /> Pi UflBTNG PFRH]'T <br />: t~/~t/g& 1~:33 PERH3[T HO <br />: Resident. addition/alteration STATUS <br />: R-3 ISSUED <br /> TO EXPIRE <br /> <br />96-~6345 <br />ISSUED <br />le/81/1796 <br />~3/3B/1997 <br /> <br />WORK OESC <br /> <br />SJTE ADDRFS,, <br /> <br />PARCEl. NlrJMBER <br /> <br />OWNER NAME <br /> <br />AF'PI~CANT <br /> NAME <br /> APPRFS$ <br /> <br />PHONE <br /> <br />CONI'RACIOR <br />PHONE <br /> <br />PI OMBFR <br /> PHI'JNI:: <br /> <br />100 FT SEWER I.INE~ 'LOOWATER I.INE <br /> <br /> ~23~6 BENTS RD NE AR <br /> <br />: FHLFN <br /> <br /> ZONE: EFU <br /> <br />: RACETTE~RAI,.PN V & ADA L-TRUSTEES <br /> <br /> ~ F <br />RACETTE,RAI.PH V & ABA L-TRIJST.ES <br />PO BOX 3]8 <br />AURORA, OR <br /> 97882 <br /> <br />COMH WOilDBIJRN INC <br />981-3141 <br /> <br />CITY: MARION COUNTY <br /> <br />Feet w~er line ~harge <br />Fee~ ~ewer ]~e charg¢ <br />State surcharge <br />R~fund <br /> <br /> OCCB: 0814~22 <br /> <br />LICENSE: <br /> <br /> Fee <br /> <br />38.00 <br /> 2.58 <br /> · 00 <br /> <br />Assessed fees : 52.58 <br />Ad ~stments : .80 <br />1'oral fees : 52.50 <br />PAYFF: RACF"rTF~RAI. PH V & AI)A [-TRtlSTFFR Tot~] paxments: 52.50 <br />Balance due : .00 <br /> <br />TH[S PERM[T IS HOH-TEAH~FER~LE ~ E~%~S ~8~ ~YS FRO~ %SSUE DATE [F ~ORK <br />H~T CO~HEHC~ ~ [F CO~TRUCT%OH CEASES FOR 6 P~%OD OF %8~ D~YS, OR [F ~ORK <br />F6%LS TO H[ET ~I.L REOU[~NEHTS OF STATE I.A~ AH~ HAR%OH CO~TY OR~%H~CES. UPOH <br />~TTTEH RF~IEST~ O~ S[X (6) flOHTH EXTEHS]OH H~Y BE GR~HTE~. <br /> <br />S~fJNATlJEE OF hPPL.~C6NI'= ......................................................... <br /> <br />DONALD E WOOOLEY~ MARION COUNTY BIJ[I.~%NG OFFICIAL. / BY ~BULL <br /> <br /> <br />