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607612
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Last modified
9/21/2023 8:15:36 AM
Creation date
8/21/2023 9:18:20 AM
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Assessor
Account Number
607612
Assessor Doc Type
Building Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
8/17/2023
MTL
061W34DC03100
Assessor Section
Manufactured Structures
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1519917 <br /> �—��, • NATURE,OF FILING(check all'that applies) <br /> U"el.il�l a c 1 r , a Cr 1 'O e <br /> $4[111t >n repro o ' o e'a prat Trip permit n torage <br /> APPLICANT INFORMATION <br /> Dealer/seller . ❑Lender Escrow/title agent Owner/buyer Legal representative <br /> Name:Michelle Linhart <br /> Address(including city,state,and ZIP): 637 W.MAIN ST.SILVERTON OR 97381 <br /> Phone: <br /> Email: <br /> HOMEINFORMATION (*required) <br /> Home ID number(if DMV X-plate number(if known):" <br /> too•7(6 ( - <br /> Moving in from another state <br /> Has no home ID or X-plate because: ❑Coming out of county deed records <br /> 0 Other: <br /> Manufacturer:CMH ALBANY 972 Model:PREFERRED PLUS Year 2021 <br /> - Manufacturer serial number HUD number <br /> ALB040412ORAB <br /> *Number of sections: 2 *Square footage:`)AGO I*Number of bedrooms: 4 *Number of bathrooms: a <br /> t„? .a�at,P <br /> *Type of roofing:4 j,. ,sll��}Type of siding: G�w.t,��,„� *Heating: 51,t.` *Cooling: 'VVA <br /> *Date of sale:s/��� *Sales price: 1124 C .y 3$ *Includes land: Yes E No <br /> DEALER INFORMATION (if no dealer, leave blank) <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> CLAYTON HOMES ALBANY,OR v S tot S 1437 CENTURY DRIVE NE <br /> ALBANY OR 97322 <br /> (541)967-8555 <br /> This manufactured structure is free and clear of all mortgages,deeds of trust, security interests,and liens.I have the <br /> legal right to sell this manufactured structure. <br /> I hereby declare that the above statement is true to the best of my knowledge and belief,and that I understand it <br /> is made for use as evidence in court and is subject to penalty for per' <br /> Dealer name(print): Dealer si - Date: <br /> Gay fro,. Homes 04' AI toy.,,/ (SIG, /2 3 <br /> TRANSPORTER INFOR ATION (if not moving, leave blank) <br /> Transporter name: Transporter address and phone: . (5141) t79 1444 y <br /> to reek '1ewck % ra,,, Lek ?0 ow VI6,74°1 <br /> Iolb� afG � i�a.frg- 6 �ti <br /> 440-2952(7/19/COM) <br /> OR Title Application-10/2019-TitleApp 11211 Page 2 004733163-00003 <br />
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