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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 -~ ,--~ _.J <br /> <br />The work will De performed Dy a registered builder. <br />Other__ <br />I have read and agree to the terms stated ~-nn t-l~e ~ s~ ~' DATE; <br />this document. <br /> <br />SUBDIVISION; <br /> <br /> ~ ~LOCK'.' <br />LOT: <br /> <br /> W.11 A "(4~ %7."~' ' ' <br /> ........ ~,,~ <br /> SECTION: TQWNSH~P- <br /> <br /> ............ .,., , ........................ ],~ ....... ~C ......... ~Q ....................... ~,.,..~z~- ~ ............................. ~ <br /> <br />TYPE: BL~,t.~zN~ PE~IT O~ APPLZCATZON NO: ~464~6 <br /> <br />;::'IA),; <br /> <br />Z(]N]TH/; <br /> <br />t]~ U A N '/' :[ T Y <br /> <br /> '< :: \; J~) ~\' ~ '~2 I~ _ ~' <br /> .......................................................................................... ::::::::::::::::::::::::::::::::::::: ~ f, .....,..,,k (,,H.:(.,,, ~,.~ <br /> <br /> -OLLO~NG HUST ~E C~PLETE~. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE T'~AT <br /> LL NECESSAry ZNF~OR~ATZON HAS BEEN PROVIbE~. <br /> <br /> ~ .... L...*., Y.~ 1)~ .... r~ -~' <br /> ,., x.,.. ~ ~ ~ S~ )~ .. .~ .. <br /> q..~ g.%.- "'";' '"' ( ]. k, <br /> c c: :~"Tr'. '( v''''''~ ..... ~ ........... ~,*'r;::'-''''/''~'''*'~-'...~r ,L';;.~2'"' "; ..... ~;¢k;4 ~.. ~Z'. <br /> '. ............ / 4.', h ~. ~.a. [:;.~:~ <br /> <br /> ~ -.. ~._~ ,/.. / . .. ; '-- '%-' ~X T~" ~ ~ / <br /> <br />FORM · MC ~-*e RSV, 4/~ OFFICE COPY <br /> <br /> <br />