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'MARION COUNTY BUILDING INSPECTION <br /> SENATOR BLDG. NO. 225 <br /> < ~ ;220 HIGH STREET NE: <br /> ..L SALEM, OREGON 97301 <br /> / PHONE: 588-6t 47 ' 8:00- q-:30 <br />· / 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />4'/65 HOR~E~.HOE CT <br />SALFJ,1, OR ~7331 376-394§ hORK <br /> <br />.......................... CASCADE-",~-A~K-' NO" 2 <br /> <br /> SiTE NU~I~ER: 15031 <br /> <br />3 <br /> <br />TYPE: ON--~i"rE SEI,~tASE <br /> <br />PE.F~IlT OR APPLICATION NO: 903716¢ <br /> <br />O0~rRAc'rOR. NO. <br />N ,~WE.L,L PE~T~R <br />4766 HORf~P-~HOE CT <br />SALE.~, OR 97:~01 37'8-3945 <br />PHONE.: 363-?343 <br /> <br />HATER SUPPLY: PH <br />TEST HOLE~ READY: YE~ <br />BITE EVALUATION NUFE~ER; <br /> <br />~STING O~IN FIELD <br />~EPT iC I'~K <br /> <br /> AF~JNI' <br /> $17o.oo <br /> <br />TOTAL A~SE~ED FEE~ $1?O.o0 <br />PRE"V IOUf5 RECE[PTS $0.00 <br />. THIS RECEIPT $170,00 <br /> <br /> R~EiPT N0: <br /> TYPE: C~ ~K ~ <br /> <br />$0.00 <br /> <br /> PAYEE: N~I~LL PETER 39123 <br /> RECEIVED BY: ~B <br /> <br /> SEE A'r'r~D ~'r FOR ~IR~T~ <br /> <br />~ THI3 i~ ~T A ~IT. THIS'~TI~ ~ST ~ TH~"A.R~ P~ ~ERE THE <br />~L~IN~ ~ BE ~EO.. iT l~ ~E R~IBZLiTY OF THE APPL[~T TO ~ THAT <br />ALL N~ iN~TI~ H~ B~ ~i~D.' ' <br /> <br />REMIARKE~ +. <br /> <br />CITY JURISDICTION: BY .............. DATE ........................ <br /> <br />OFFICE COPY <br /> <br /> <br />