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MARION COUNTY BUILDING INSPECTION
<br />SENATOR BEDG. NO. 225
<br />220 HIGH STREET NE
<br /> SALEM, OREGON 97301
<br />
<br /> PHONE 588-5147
<br />CODE-A-PHONE 4:30 P.M. - 8:00 A.M.
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<br />¢,~GNATURE OF APPblGANT:
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<br /> DATE[: 09/01/$? Tiff/E:, 4:07,:5,3,o .......... ,,, .................................................
<br /> HUff/MEL, 8ILL
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<br /> 215 F~T ST
<br /> DET~IT OR 97342
<br />
<br /> ~4695 ~ 133RD
<br /> T~RD. OR
<br /> ~E: ~iTE NU~ER: 2271
<br /> VA~ATI~:
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<br /> 8 ' 17 .... t ................ t .............. ~ ................. ~ ................ ~--.-4 .................. ~. 1.05
<br /> 50 , 100 ~ 5000.00 i SF
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<br />'~PE: ~-S[TE SA~E ~TER ~PPLY:
<br />PE~T OR APPL[~TZ~ NO: 3893 $ZTE ~ALUAT~
<br /> ~T[NG T~K SIZE,
<br />~T~OR, NO. ~Z~T~NG D~[N FIELD L[N~:
<br />HU~EL, BZLL SEPTZc T~K
<br />14~95 ~ 133~D
<br />T[~RD, OR
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<br /> Z T~ ~T I ~ ~NT
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<br /> , ,,,:,: .,,.'.>"~CE, ~E'
<br />PAYEE: ...... ,' '' ~NVO[CE
<br />~ECE[VED BY= J~ ':-x:..... ........
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<br />OFFICE COPY
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