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Other <br /> <br />have read and 8gree to the ~erm$ stated on the reverse side <br /> <br />MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 586-5147 <br /> CODE:A-PHONE 4:30 P,M., 8:00 A,M. <br /> <br /> DATE; <br /> <br />o2/o2/9o <br /> <br />,SITUS A D OPC~IS, JAGKIE <br /> <br /> 5777 VALLEY VIEN RD <br />TURNER <br /> <br /> TA× L0~: CATEGORY: <br /> i coNs~ucfib~ 'i'Y"Ei OCCUPANCY:RESIDENTIAL <br /> <br /> SE , <br />OR,, 97392. ' I ¢ , <br /> D1ARION COUNTY NO ,o o, ,,[~R00MS <br /> <br />GREG KA'I'H : RENTER <br />13472 ~OODLAND LANE SE TURNER <br />PHONE; 769-4282 <br /> :BLOCK: <br /> <br /> SITE NUIV~ER: 9363 <br />'TOWNSHtP: : y,i~4~AT I ON .' ZONE: <br /> <br />MAp: <br /> <br />TYPE: PLUMBING <br /> <br />PER~IT OR APPLICATION NO; 9021732 <br /> <br />CONTRACTOR, NO, <br />HARRIS, JACKIE <br />GREG KATH : RENTER <br />13472 ~OODLtClD LANE SE TURNER <br />PHONE~ 769-4262 <br /> <br /> iTEM <br />N08ILE HONE 8E~ER AND WATER 6ONNECTION <br />FLEET SURCHARGE -ZONE <br />PLUMBING STATE SURCHARGE <br /> <br />TOTALASSEESSEDFEES <br />:PREVIOUS RECEIPTS <br />THISRECE[PT <br /> <br />QUANTITY AMOUNT <br /> 1 $25,00 <br /> $3.84 <br /> $~.25 <br /> <br />$30.09 <br /> $0~00 <br />$30.09 <br /> <br /> BALANCE DOE $0.0o <br /> <br /> PAYEE: KATH, GREG //./~ RECEIPT NO: 23038 <br /> RECEIVED, --- .... BY: ,P~, ~- ::: ~:~ --¥: :: ~:' ~: ~ : TYPE; CK~~___~CHECK ~: -181 <br /> * 'fl'liS IS NOT A PER~{T, THIS APPLI~ATZON;I~U~'-T A R~Z~ P~ ~E~ ~E <br />~I~ ~ 8E ~ :Z~ iS ~E:,~IBILIW ~ ~E APPLI~ TO ~ ~AT <br /> <br />PLAN REV[ B4: <br /> <br />REMARKS: CONN R~0553 <br /> <br />DATE , CITY JURISDICTION: BY DATE <br /> <br />OFFICE COPY <br /> <br /> <br />