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MANUFACTURED STRUCTURE ,44J <br /> IIFMOFTRANSOORTATgM �314 Y� <br /> I<OR VEHICLE SERVICES BRANCH TRIP PERMIT MH 356643 <br /> AYE%UE NE SALEM OR 17114 <br /> rip permit DOES NOT authorize operation of loads that exceed legal highway limits.Any movement over the highway of a manufactured structure that exceeds <br /> highway limits(including all structures over 8 1/2 feet wide or 14 feet high)must be covered by a Transportation Permit.For information on Transportation <br /> is call(503)373-0000. <br /> IEW Manufactured Structure ❑ USED Manufactured Structure ❑ REPLACEMENT Permit FEE: $5.00 <br /> 4T(CITY) DATE ISSUED EXPIRATION DATE DEALER OR MOVER DEALER/TRANSPORTER NUMBER <br /> n5v i J Li) //-Flo-aO 17-/ -00 Lcgii)r/pnl Home_ <br /> NUMBER YEAR MAKE VIN(VEHICLE IDENTIRCATION NUMBER-MUST BE COMPLETE) OREGON TITLE NUMBER OF PREY.TIRED IN OREGON) <br /> A606 Sr`/Vercre JI <br /> 3/LAND USE PERMIT NUMBER • <br /> SIGNATURE OF ISSUER �= <br /> )0- 037 2 <br /> PREVIOUS OWNER(PRINT LAST,FIRST,M.I.) NAME OF CURRENT OWNER;it(FAINT LAST,FIRST,M-I.) al <br /> evcves-�/Grip sfern /fonui -�-Ee.v�son, Roger �, rs� . <br /> IS LOCATION( TREET ADDRESS OR MAP AND TAX LOT NUMBERS) NEW LOCATION(STREET ADDKESS OR MAP AND TAX LOT NUMBERS) c' <br /> �sz) 4rac rP s s Wcu j 68710 <br /> .S2YenaJ Wcui NSF <br /> STATE ZIP COD COUNTY CITY STATE Z CODE COUNTY <br /> tbu—vn 6/?J P907/ 1)')a.vror) S' (JI 1 OIL) 4/z3o/ Mart on <br /> UCTIONS: <br /> )of of taxes paid must be attached to the copies forwarded to DMV.Proof may be a copy of the Dept.of Revenue,Form 113 or a signed <br /> lement from the County Assessor and Tax Collector. <br /> not use this to move a manufactured structure that has been exempted from title and registration requirements. <br /> mplete the entire location address in appropriate areas. <br /> ite the expiration date in the space provided at the top of the form.Complete the same expiration date at the bottom of the form on Copy 5 in <br /> 3e,legible numbers. <br /> lure to comply with ORS 820.560/ORS 820.570 could subject you to a citation,a civil penalty,the suspension of your dealer license,or <br /> ,ocation of your transporter certificate. <br /> 0 <br /> • COPIES I THROUGH 3-DELNER OR MAIL TO DMV. • COPY 4-RETAIN FOR YOUR RECORDS • COPY 5-ATTACH TO REAR OF MANUFACTURED STRUCTURE <br />