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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 <br /> <br />tv~F(I iN, RO~gRr <br /> <br /> 95~7 5'['AYrON RD SE <br />AU~VILL~ OR 9'(~5 <br /> <br />CONTRACT CITY U~S <br />MARION COUN'I Y NO <br /> <br />18 <br /> <br /> 9. <br /> <br /> SiIE Nu~ER: <br /> VALUAT i (~; <br /> ZONE <br /> <br />9S <br />AC NO NO <br /> <br />MAP <br /> <br />WATER EAJPPLY= PW <br />f F_:,~ T HOL~ <br />~iTE EVALUATiC~N NU~ER: <br />~IS[ING 'F~K SIZE: <br />EXISTING O~IN Fi~LO LiNgS: <br />S~P~ iC T~K <br /> <br />TOTAL AJ~Sb55ED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPY <br /> <br />DUE <br /> <br /> R~C~.[V~.0 BY: P~J ~) ......................... <br /> "3h-E A) [AC~D ~UM~N~ FOR ~i~T~ OF ~-~ITE <br /> <br />* 'THI~ 15 NOT A ~iT. THI~ ~LI~TI~ ~T ~ TH~ A R~I~ P~ ~ERE THE <br />~JOI_L~iNG ~S) Bg ~gET~D. iT IS ~E R~SiBILITY OF THE APPLI~T TO ~R~ THAT <br />ALL NEC~ IN~TI~ H~ <br /> <br />CiFY JURISQICi'i01'~: BY ...... OAIE .... <br /> <br />OFFICE COPY <br /> <br /> <br />