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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: ~8-~147 8:00- 4:30 <br />24 HOUR CODE.A-PHONE: 58~-7904 <br /> <br /> am pm'forming w~rk on a I~Olaerty I own or o~?upy. <br />I am a registered builCle¢ OR ( } the autl~orlzeo representabve <br />of a registered bu Ider. <br /> <br />Other , <br /> <br />DATE: <br /> <br />TAX LOT: <br /> <br /> ; ....................... CONTRACT CITY: <br /> 10664 SILVER FALLS HI6~'-PA~AY SE <br />~ ~RI~ ~NTY <br /> <br />NO <br /> <br />· OCCUPANCY: <br /> <br />LOT. <br /> <br />WIDTH; <br /> <br />2365g' <br /> <br />AU'rHORIZAT!,ON NOT,ICE - P~O. <br /> <br />PAYSIE; <br />RET.;E [ VEO BY: <br /> <br />', ..... ' PREViCRJ~ R'ECEJt PTS <br /> THIS RECE J PT <br /> <br />BA~E <br /> <br /> QUAN T,[ TY AMOUNT <br /> 1 $105.00 <br /> <br /> $105.00 <br /> $0. O0 <br /> <br /> $0, O0 <br /> <br />RgCgIP~ NO: <br /> <br />RF_T4AR~: AUTH <br /> <br />DONALD E. ~3ODLE"Y, MARION CC~NTY BUiLDiNG OI=F[CiAL / 8Y <br /> <br /> <br />