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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> CODE-A-PHONE 4:30 P.M, - 8;00 A,M, <br /> <br />SITUS ADDRESS' , GON~TRU~TION ~YP~: OOCUPANCY: <br /> <br />SEOTrON: <br /> <br />:TOWNSHIP: RANGE: <br /> <br />: ~ONE: MAP: <br /> <br />':-{,,E~'T SURCPIARGE ,,~ZON~ 3 <br /> <br />TOTAL, ASSESS, ED FE'":S ~-;,S~. ,; ~ <br />PR~'V .( CU;$ REDE; PTS <br />~tS RECEIPT $0'~: ,';-: <br /> <br /> ~ ............... :':-"===:=: ===,= ....... L...%-.%,'-"- ...-.,, ,-' .................................. 'L ............. <br />"TFIiS ZS NOT A PE~ZT, THIS APPLZCATION f4JST GO llNROjGIq A R~IF_.N PI;~CF....%S ~fiEF4E THE <br />FOLLOWING ~'~,,,JST BE COMPLETED. IT tS THE RBSPONSiBILITY OF THE A~PLTOANT. TO ~RE --~H,~"': <br />ALL NEC~ARY INFOR24ATZON HAS BEEN PROVIDED. <br /> <br />OFFICE COPY <br /> <br /> <br />