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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 - 4:30 <br />24 HOUR' CODE-A-PHONE: 588-7904 <br /> <br />of a registered builder, <br /> <br />Other <br /> <br />TOTAL ASSES~EB FEES <br />PRE¥IOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> <br />~,2'l 1.10 <br />$21. I.. 1.0 <br /> <br />BALANCE <br /> <br /> F'¢'(EE: Ca:~:i.~', 1 Aw](~g / S.a '~ia~ - ~es INVOICE 6(t564 <br />'RI:.CE],VEb ~Y: :}m ........................ ],,__'___:_ ............. TYPE: ±N CHECK ~: 0 <br /> THZ~ IS NOT A PERNIT. THIS APPLICATION MUST 60 THROUGH A REVIE~ PRgCESS WHERE TI4E <br /> ~g~OWIN6 MOST BE COMPLETED. IT lis THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br /> ALL NECESSARY tHFORMATIOHHAS BEE~ PROV~ED~ <br /> <br />LS-':i. 5 <br />R S- 15 <br /> <br />FORM # MC 16-5¢~ R~:V, 4/90 OFFICE COPY <br /> <br /> <br />