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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO- 22§ <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />Other <br /> <br />SITUS ADDRESS; <br /> <br /> PHONE $88-$1~7 <br />CODE-A-PHONE 4:30 P.M. - 8;00 A,M. <br /> <br /> S~NATURE OF APP~=~OANT; <br /> <br />, TAX LOT; <br /> OONSTRUCTIO~ TYRE: <br /> <br />· CONTRACT'CF~Y: I UGB: <br />I~,~,i'~; ON COUNTY : lO <br /> <br />: OCCUPANT I. OAD; <br /> <br />MAILING ADORESS: <br /> <br />u';ON !:".': '74 g-;2522 <br /> <br />.... ~.PP,.,. ~, ...... N NO: S 00.. ~ u,:, <br /> <br />,C(.X',iT F;A:~'?OR, <br />... f ;_' f_'"N ,'~ F_' NO: <br />S'"'U~D.?¢Ai'4':', STEV~ & <br />F~.a. NE <br /> <br />QUANT; TV A>!CLiN"- <br /> :S,:: ;:! :", <br /> <br />TCITAL~SSESSEOFEES <br />PREVZOUS R~C_ZPTS <br />TH;S RECEZPT <br /> <br />~.&~AN ..... E~IE <br /> <br />:~ ~HZS J$ NOT A PERt4]T. TH;S <br />FOLLO~]NG NUST 8E COMPLETED. <br />ALL N~CESSARY ZNFORNATZON <br /> <br /> $24. ;.'4 <br /> <br /> RECE;[~T N,O: ~824. <br />TYPE: CK CHECK ~: <br /> <br /> A REVZ~N PROCESS ~ERE <br /> 3F ~E APPLIC~T TO ~RE T~AT <br /> <br /> REVIEW: 8Y <br />:,~[i?IAF,~i',S. EX. '~' <br /> <br />OFFICE COPY <br /> <br /> <br />