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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />PHONE: 588-514T 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 ~ ~ <br /> <br /> 5458 Dll~lrRE DR S~: ', ', <br /> <br />  ~ SiTE NUMBER: <br />F'HONE~ 58~-2664~ ~ VALUgTIOIqa <br /> <br />RUD~SH~USER~ RICK <br /> <br />F'HOHE: 585.,-2664 PHONE: <br /> <br /> l'rE~ <br />BUILDING FEE <br />PLAb) REVIEW <br />8U23LDIHG STATE SURCHARGE <br />ZOHthlG SUR6HARC~E <br /> <br /> QUANTITY AMOUNT <br /> $188,,50 <br /> <br /> $9,,4~ <br /> $9,43 <br /> <br />lOIAI, ASSESOEg FEES $329.89 <br />PREVIOUS, RECEIPTS $0.00 <br />THIS RECEIPT <br /> <br />~ALAN~E DUE ¢8.88 <br /> <br />~ THIS IS NOT A PERMIT. TMIS APPLICATION MUST 60 THROUGH A REVIE~ PROCESS {tHERE THE <br />FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT <br /> LL M£CESS~RY INFORMATION HAS BEEN PROVIDEB. <br /> <br /> BY <br /> I:~'lY JURISDICTIOHD BY, __ ...... ~. DATE'_ ............. B,ERGY P~'ftq ~ ........... <br /> RE~ARKS~ ~;ARAGf::/HHOP <br /> <br />FORM # MC 1 $-5e REV, 4/90 OF FIC E COPY <br /> <br /> <br />