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MARION COUNTY BUILDING INSPECTION <br />SEN/~TOR B~-DG, NO, 225 <br />220 HIGH'$TRE~-T NE <br /> SALEM, OREGON 973O1 <br /> <br /> PHONE: 58~-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 585-7904 <br /> <br />~c~8~2 TIME: 10:39:26 <br /> LEA, .HARVEY .................................... <br /> <br />SIGNATURE OF APPL, KiAN'~[ ....... . ......................... <br /> <br />REStDEN'F <br /> <br />VALUATION: <br /> <br />TEST HOLES <br />SITE EVALUATiC~I <br />~XI~TiNG T~K SIZE: <br />~iST~NG D~IN FIELD LIN~ <br />~TIC T~K ~PEO~ <br />PRiZeS NO- <br /> <br />QUANTITY <br /> <br />,TOTAL AE~ESSED FEE.~ <br />PI;~V[OJ~ REC~[PT~ <br />THIS' RECEIPT <br /> <br /> $210,00 <br /> <br /> t210,00 <br /> 130.00 <br /> $80.00 <br /> <br /> $o.o0 <br /> <br />42281 <br />2544 <br /> <br /> PAYEE.- M &I M CON~,'rRUCTiQN RECEIPT NO: <br /> RECEIVED bY: CL · TYPE: CK CHECK <br /> <br /> SEE ATTACHED ~T FOR ~[R~T~ OF ~-~ITE ~GE ~Y~T~. <br /> <br />~T~TI~ FAI~ ~. ~ ~ ~R~ ~ ~TATE ~ ~D ~I~ ~TY ~ILDING <br />Z~ING O~IN~, THi~ ~IT NUL~,~D. <br /> <br />REMARF~: ALTEP, AT i~ ~ <br />DONALD E. ~X3ODLEY, IVJAR1ON COUNTY DU.[LDING OFFICIAL / BY <br /> ......................................... <br /> <br />OFFICE COPY <br /> <br /> <br />