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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: 588-5147 8:00 - 4:80 <br /> 24 HOUR CODE-A-PHONE: 588-?904 <br /> <br />have read and agree to the terms stated on the reverse side of DATE; <br /> <br />, JLJ L.~ ......Ch/'~ .... ~ .... <br />I SITUS ADDRESS: I CONSTR[,JCT~ON TYPE'. : OCCUPANCY <br /> <br />! :1.]:L44 t4II.,L CJ:',.'EEK F,D SE ; OONTRACT CITY: <br /> ~UHSViU_,E G ~ 97 ~2: ~; H~:~] 3N COUJ,J'T'Y <br /> <br /> ~ NO O~ BEDROOMS <br /> <br /> SZTE NUN~ER: <br /> <br />C, Ot,!'t'RC4:;TO R,~ NO,, <br /> '44RK,-,-Ot, IF <br />:i.:l,&f,~ GR6Nlr' PI. <br />_EOAN(I,:~ 97355 <br /> <br />PER~IT OR APPLZCAT%ON ~0: 59727 <br /> <br />HEI'~H~NIt:i~L. 1,:~6~:;1:.: ELD.-: <br />Hli,CHr/N]:C~;L, S'I'~TE S <br /> <br />!:' ,/.1YJ'_:: L-: tl HC~g!K-ONE <br /> <br />(:TUt-1N'f' ]: 'f'Y <br /> i <br /> <br />'FCYTAL ~8SESSFI) <br />I kEV,LO ,t,,~ <br /> <br />RECEIPT <br /> <br />CONSTRUCTIO~ CEASES FOR A PERIOD,OF 18~ OAYS~ OR iF CONSTRUCTION FAILS TO ~EET ALL <br />E~UI~EMENTS OF STATE LAWS',:~ND NARION COUNTY DUILDING AND ZONING ORDINANCES, THiS <br />ALL ~ECO~E NULL AND VOID; <br /> <br />OFFICE COPY <br /> <br /> <br />