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• <br /> ,. •.. o F`o State of O n <br /> 4i �� Department of-Co' <br /> f Consumer and Busmes§SerJices <br /> Qty �°� ;0 Building Codes Division <br /> 1. <br /> vtufi rI <br /> N','; I,NWAi,-,—% X 1535 Edgewater St NW <br /> .`.��.r,,: / • Mailing Address: PO Box 14470 <br /> 69" Salem,OR 97309-0404 <br /> (503)378-4530,FAX(503)378-4101,TTY(503) <br /> Web:mhods.oregon.gov Email:mhods.bcd@oregon.gov <br /> Manufactured Structure Transportation Permit , A-- 3 4 S -7 38 Q <br /> • <br /> 21-11937-TRIP U <br /> This permit authorizes a qualified transporter to move the identified sections of the identified home to a destination site within the <br /> state of Oregdn. The section move must occur between the Issue Date and Expiration Date specified on this permit. <br /> This permit must be carried by the transporter during the actual move.This permit authorizes movement of all home sections <br /> identified:. ._.. __. . ... <br /> Issue'Date: 11/23/21. Not Valid After Expiration Date: 12/15/21 <br /> Applicant:. HILLS, KASANDRA Phone: (503) 949-7943 <br /> P.O. BOX 11 Email: SANDY.PIPPIN@YAHOO.COM <br /> MILL CITY, OR 97360 <br /> . Home Information: <br /> • <br /> Home ID: 256225 . <br /> Manufacturer: SKYLINE HOMES Model: Unknown • <br /> Section Serial Number ' HUD Number <br /> 1 32910241XA ORE 155109 <br /> 2 32910241XE ORE 155110 • <br /> Original 33639 N SANTIAM HWY SE County: Marion . <br /> Address: GATES, OR 97346 1\ <br /> c I 3371 I 'Rau l yc c L4v-t_ <br /> Destination 33733 RAILROAD AVE County: Marion <br /> Address: GATES, OR 97346 • ' <br /> Transporter: HILLS, KASANDRA Phone: (503) 949-7943 <br /> Email: SANDY.PIPPIN@YAHOO.COM <br /> • <br /> S).-ef .0-'rrl a t 1 \_ A on . • .. <br /> • �o co, <br /> jA541 <br /> • <br /> 11/23/21 10:30 pm Page 1 of 1 G:\myReports/reports//production/01 <br /> STANDARD <br />