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608506
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Last modified
10/9/2023 11:22:02 AM
Creation date
10/6/2023 1:31:16 PM
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Assessor
Account Number
608506
Assessor Doc Type
Trip Permit
Doc Type Date
9/27/2023
MTL
082W09D001000
Assessor Section
Manufactured Structures
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• <br /> (95b5 O5C h 81- 8F ( &J.e l <br /> NATURE OF FILING (check all that applies) <br /> 1 to p s t' interest ❑ Change ownership tl n t o 1 ' . <br /> I i� eaKty [KA iGty1� �( p r } s adds ❑� Trip permit Utaertulantorage <br /> er: - <br /> APPLICANT INFORMATION <br /> ❑■ Dealer/seller ❑Lender ❑ Escrow/title agent ❑ Owner/buyer ❑Legal representative <br /> Name:HOMES DIRECT OF OREGON LLC MILLERSBURG <br /> Address(including city,state,and ZIP):3838 PALM HARBOR DR MILLERSBURG OR 97321 <br /> Phone:541-928-2083 <br /> Email:TANYA.ABADILLA©HOMES.DIRECT <br /> HOME INFORMATION (*required) <br /> Home ID number(if known): DMV X-plate number(if known):NEW b bSb <br /> ❑Moving in from another state <br /> Has no home ID or X-plate because: ❑Comingcounty out of deed records <br /> ❑Other: <br /> Manufacturer: PALM HARBOR Mode1:310AF15762R Year: 2024 <br /> Manufacturer serial number HUD number <br /> PHH3100R23-15639A ORE 562212 <br /> *Number of sections: 1 *Square footage:1140 *Number of bedrooms: 2 *Number of bathrooms: 2 <br /> *Type of roofing:ARCH *Type of siding:FIBER CEM *Heating:ELECTRIC *Cooling:NONE <br /> *Date of sale: 7/19/2023 *Sales price: $139,120.00 *Includes land: ❑Yes ❑No <br /> DEALER INFORMATION (if no dealer, leave blank) <br /> Dealer name: Dealer license number: Dealer address and phone: <br /> HOMES DIRECT OF OREGON LLC MSD-523 3838 PALM HARBOR DRIVE NE <br /> MILLERSBURG MILLERSBURG OREGON 97321 <br /> 541-928-2083 <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 is <br /> made for use as evidence in court and is subject to penalty for perjury. <br /> Dealer name(print): .1 r signature: Date: <br /> HOMES DIRECT OF OREGON LLC MILLERSBU 9/P`7/, <br /> TRANSPORTER INFORMATIO (if not moving, leave blank) <br /> Transporter name: Transporter address and phone: <br /> BENNETT TRUCKING&TRANSPORT 409 BIGHAM BROWN RD <br /> JACKIE YOUNG EAGLE PT OREGON 97524 <br /> 541-879-3444 JACKIE YOUNG <br /> 440-2952(7/19/COM) Page 2 <br />
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