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MARION COUNTY BUILDING INSPECTION
<br />SENATQR 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 />The work will be berformed by a registered builder.
<br />Other
<br />
<br />OWNER. ' ........... TAX LOT;
<br />~ MIll,[',H::' & MARY FI,r';MiR ] ?0260'"'49fit
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<br />CONTRACT C~TY: UGB'. ! O~CI~AN~
<br />DETRO IT
<br />
<br />TYPE: PLUN~N~
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<br />CON fkACl
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<br />i~.)445 I,,IAZE]_,[;REEH RD
<br />,<f I..",/E R 101',t~ OR
<br />PHONE,; 87;~-4240
<br />
<br />PER~IT OR ~PPLZCATION .... ................
<br />
<br /> 1 l F,,1
<br />!~A'I'ER I_.:l:,l,I;i,.'.'S,~, ].ST 100 FEET
<br />FI.,UI'I~"K£NI; BAS[-; FlEE :,
<br />~ LUMT. IN6 STATE: SURI2FIARI;E
<br />
<br />aUAN',':[.~.,v~
<br />
<br />ri2,,
<br />
<br />$42,, 00
<br />
<br /> LL[,L)VE;, BY, i,R
<br /> .............................. ...... R.,; ................ .' .,. _ ,'_ ........ '.,_Z.L_ ._..; ......................
<br />
<br />FL~LLU~Ilqb MU~.T ~E ~HE APPLICANT TO ASSURE THAT
<br />LL NECESSARY INFORMATION H~S'i:~,EEN:;~,','PROV~I)E]):;,,
<br />
<br /> ,:.... ...............
<br />
<br /> .... ~A~,K,*~ UAI,..R .,[Fit,;. t.,,'r 1,~0
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<br />OFFICE COPY
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