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MARION COUNTY BUILDING INSPECTION <br /> S~NATOR BLDG. NO. 225 <br /> -' "220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:30 F~M. - 8:00 A.M. <br /> <br />I am performing work on 8 property I owr~ Or Occupy. p~.- <br />I am a registered builder OR ( ) the authorized representative SIGNATURE OF APUCCC' ~... <br /> <br />I hsve read a.d a{]ree to the terffi8 stated on the reverse Side of DATE: ,~ -- / ~ ~ ~O ........... <br /> <br />°WN~ATE: 04/16/'90 TIME: 11: 4,4: 38 TAX LOT: CATEGORY: <br /> <br />sr~usAooREss:I~'~ERG R V PARK ~,0316-935 <br /> CONSTRUCTION TYPB: OCCUPANCY: <br /> <br />COr,~ERC rA~_ <br /> <br />21599 DOLORBS NAY NE <br />AURORA OR 97002 <br />USEOFBUILDING: MARION COUNTY NO <br /> <br />MAILINGADDRE$8; AI'4USENENT AND RECREATIONAL BUILDII~w~s~°N: <br /> <br />SAME <br /> <br />PHONE: <br /> <br />678~2646 SITE NUMBER: 9565 <br />BLOCK: SECTION: TOWNSHIP: RANGE:VALUATION ~ONE: $9,000 _'~,~: <br /> <br />WIDTH: <br /> <br />DEPTH: <br /> <br />AREA: 9 UNJTSI 4S IRREG.~T: l~ CORNER: ~ <br /> 5.8200001? AC NO NO <br /> <br />TYPE: BUILDING PERMIT OR APPLICATION NO: <br /> <br />CONTRACTOR, NO. 494 <br />GUN-CRETE CEMENT CO DBA CASAOE <br />6775 SM MCE1NAN RD <br />LAKE OSNEGO, OR 9?035 <br />PHONE: $20-6~74 <br /> <br /> ITEM <br />BUILDING FEE <br />PLAN REVIEN <br />FLEET SURCHARGE ~ZONE 6 <br />BUILDING STATE SURCHARGE <br />ZONING SURCHARGE <br /> <br /> 9023222 <br />ARCHITECT/ENGINEER, NO. <br /> <br />PHONE: <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS ,RECEIPTS <br />THIS'RECEIPT <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $?4_50 <br /> $48.43 <br /> $7.68 <br /> $3.79 <br /> $3,73 <br /> <br /> $o,oo <br />$138_07 <br /> <br />;BALANC~ , DUE $0- 00 <br /> <br />SEPTIC= <br /> <br />RFJV~RKS: <br />HEIGHT: <br /> <br /> PAYEE GUq-CRETE T C~ DB~CASADE L <br /> <br />¢OLL~ZNG MUST BE COMPLETED.:,'~';,~ ~BE:~ RES~SIB,Z~,ZTY OF,THE APPLZC~T TO A~URE THAT <br />ALL NECESSARY ZNFO~AT H~;',,BE~" <br /> <br /> C~TY JURISDICTION: BY ~TE <br /> DATE' <br /> <br /> DATE' FR,,~ LS¢ eRS 6~ RR ¢/ SP <br /> <br />TOTAL SO FT: 500 STORIES: <br /> <br />PLAN.ACTION: <br /> <br />~O.M ~ uc ls-5~ ~EV ~/~ OFFICE COPY <br /> <br /> <br />