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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />~'20 HiGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CODE-A-PHONE 4:30, P.M. - 8:00 A.M. <br /> <br /> ,SHAW, SAM ! 56~4-000 t RE$I DEflT[ 4L <br /> <br /> ?$ KEENE LANE ~E i ~,1~ o~ ~ u~e: ~UPA~ ~O~:: <br />~VI LLE OR 9732S ' <br /> ....................................... ~~..-L_-~o ......... ~ ~ ....... <br /> <br /> 2915 HAt~r~HO~NE <br />: SALE~I g7303 <br /> PHONE: 508-6689 <br /> <br />· :~ o ~. ' ~-~/ ~ ~ .... ~ ~'UN,~ <br /> ~ _~ 33~0000 <br /> <br /> ~PE: ~ITE ~ <br /> PE~IT OR A~LI~TI~ NO: ~203~ <br /> ~T~T~ ~ ~_ <br /> <br /> 2915 ~E <br /> ~L~ 97303 <br /> ~[~ 58~-6689 <br /> <br /> SITE NUMBER: <br /> VALUAT ! (3~: <br /> MANGE <br /> <br /> 8~ <br /> <br /> NO <br /> <br />~TER ~UPPLY: <br />T~T H~ R~DY: <br />SiTE ~ALUATI~ NU~ER: 10938 <br />~ISTIN~ T~K SIZE~ <br />~ISTING D~IN FIELD <br />~TIC T~ <br /> <br /> EF~d :.._ _A6 j <br />NO <br /> <br />ITEM <br />8 MONTHS OLD <br /> <br />PAYEE: <br />RECEIVED BY: J8 <br /> <br /> TOTAL A~D:~$ED FEES <br /> ' PRE-VICXJ$ RECEIPTS <br />" ,::, ~IS REd,PT <br /> <br />QUANTITY AMOUNT <br /> 1 $110.00 <br /> <br /> $110.00 <br /> $110.00 <br /> $o.00 <br /> <br />RECEIPT NO: <br />CHECK <br /> <br />$0,00 <br /> <br />SEE ATTAO'-IED DOCUNt~T FOR RE(~IRE~ENT$ OF ~ITE ~ ~T~.- <br /> ~ * ~s ~ ~ =~o ~ ~ ~ ~E~T~. <br /> ~IS <br /> A <br /> V~D <br />~Ti~ FAIG ~ ~ ~ ~I~ E ~A~ ~ ~D ~I~ ~ ~ING ~D <br />z~ ~z~. ~s ~T:~ ~ ~ ~o <br /> <br />DONALD E. h4SX3OLEY, htARION ~C, CUNTY B/J[LOING OFFTCIAL / BY <br /> <br />.o.~. Mc ~,~-~. -~v e/a, OFFICE COPY <br /> <br /> <br />