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MARION COUNTY BUILDING INSPECTION
<br />'~'SENATOR BLDG. NO. 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
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<br /> PHONE 588-5147
<br />CODE-A-PHONE 4:30 F~M. - 8:00 A,M,
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<br />SIGNATURE OF APPLICANT:
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<br /> BAT'E:
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<br />TAX LOT:
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<br />CONSTRUCTION TYPE:
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<br />CATEGORY:
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<br />OCCUPANCY:
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<br />SUBDIVISION:
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<br /> ;,,,,R~ , 9?224
<br />LOT: BLODKI
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<br />SECTION: TOWNSNIP:
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<br /> ~.AL ,ta~- ~""'" r,~'
<br />RANe UAT!ON: ZONE ...... ~A~:
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<br />25 . O000 X,.C 'NC
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<br />ARCH~¥ECT/ENG~NEER, ~'"'
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<br />TOTAL ASSESSED FEES
<br />PREVIOUS REC~.~T¢(
<br />TLIS'RECEiP]
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<br />OL,, ~.]
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<br />8.ALANCE 3L, E "'
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<br /> ;,r-: ,,,,", ?' ,
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<br /> ~, ~:',;(} ;{~ ,,.,%. '/,$EID ~ER~'~T TM X~'f$ PERM.T.,I EXPIRES ,180 DAYS ?~O'4 ];TS f~S.E C","E, :.:
<br /> ~..;t..)",,SrRt_!:; ION ¢;EAS~.%
<br /> ;<.cT,~U [ :~!:;-,,~,,(:',,,;' '2 ?::: '3
<br /> o~-,,/ ..... ¢~!i{;0"¢'1'.. ", .......... ~,'ql' ~,.':,l'.l D ...............
<br />
<br /> ...... · ,, .,.> ~', ".-'- -;, "9 -.a-'9 RR-,9 S°,~_ ....
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<br /> :: .... ~,r,. ~,"'~<AC,:' L:.,D(,} fork FARM v,,QJ?MENT P%"RSOX:~.L USE
<br /> ....
<br /> ';):",',:~,_C E. ,9OX'....ey 'v.¢',c,'."3~', COUN~'Y SU,T',r'"'SG C.,,*-¢','-.':.~,' .' ~,~ V~,,,~,/(~~''''-
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<br />C-ORM # MC 15.56 REV 11/88 OFFICE COPY
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