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M,~RION COUNTY BUILDING INSPECTION <br /> ~ SENATOR BLDG. NO. 225 <br /> 220 HIGH STREET NE z~$_ '~ <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588'-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />have re~d and ac~ree [,3 the terms'~i~,i~d on the reveme side of <br /> <br />'SECTION: <br /> <br />WIDTH: <br /> <br />DA?E: ......... <br /> <br /> ....... ff~.~.~. ~,N.~ ......... <br /> ' "(~b~mw~iS~ ....................... <br /> <br /> VA_UA <br /> <br />...'] ~ j .............. ~.. _' .......... <br /> <br /> f~l' HOL~ <br /> ~ITE ~AL~A]i~ NUkE'F:: <br /> ~ISTING ~ANK S[Z~ <br /> <br /> EXISt :NG '5vS'¥[~ ~-' . <br /> E ¢. ,_ ~',';,'T <br /> <br /> PRE~iOU~ RECEIPTS <br /> TH[~ RECEIPT <br /> <br /> ~A~,~CE ' ~E <br /> <br /> * THis ~$ NOT A 9E~iT. THi$,'~PLZ-~T[~ ~$T'~ TH~ A R~iSW ~ ~ERE ~'~ <br />~L~[N~ ~$T BE ~PLETED.' IT JS TH~ ~[~[L[TY OF, THE A~PL[C~T TO .~R~ <br /> <br /> <br />