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607100
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Last modified
4/26/2024 11:01:01 PM
Creation date
4/26/2024 11:57:08 AM
Metadata
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Template:
Assessor
Account Number
607100
Assessor Doc Type
Trip Permit
Secondary Assessor Doc Type
Jacket
Doc Type Date
4/24/2024
MTL
063W140000800
Assessor Section
Manufactured Structures
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SECTION.6-.. :.:.:: `` NEW,OWNER ACKNOWLEDGEMENT.(Onename:perbox):,....::•:i,':1' ::';: <br /> : 0 Person 0 Business El Trust 0 Guardian <br /> > = �"Legal Name.Fick, Paul Phone:503-931-7679 <br /> , (last,first,middle) <br /> ill";"fj, Mailing Address:8782 Ravena Dr N <br /> ' `-. City:Salem State:OR ZIP:97303 <br /> _�' <br /> Email: <br /> `.;W Right of ❑■ Yes ❑No <br /> r!.Z- LLB; Survivorship: <br /> . :.. <br /> , <br /> Signature: Date: <br /> ' • ``•' ❑■ Person ❑Business 0 Trust 0 Guardian <br /> ,N`,q Legal Name: <br /> Fick Teresa Phone:503-931-7679" , (last,first,middle);-'u:1 Mailing Address:8782 Ravena Dr N <br /> ',,, :4: City:Salem state:OR LIP:97303 <br /> k. Email:teresafick8@gmail.com <br /> S:4? Right of <br /> W 0 Yes ❑No <br /> Z::y : Survivorship: <br /> „; Signature: Date: <br /> -,,' .{ El Person ❑Business 0 Trust ❑Guardian <br /> M <br /> • <br /> r`rym,; Legal Name: <br /> Phone: <br /> rst,middle <br /> Rast,f J <br /> LC.1 Mailing.Address: <br /> ?:tilT= "' <br /> City: State: ZIP <br /> Email: <br /> µ.W; Right of ❑Yes ❑No <br /> :Z Survivorship: <br /> y <br /> Signature: Date: <br /> 0 Person ❑Business El Trust El Guardian <br /> ', Legal Name: <br /> (last,first,middle) Phone: <br /> ...:....cc,:„ <br /> '':W '• Mailing Address: <br /> .�? : City: State: ZIP: <br /> Email: <br /> ua < Right of El Yes ❑No <br /> t Z",•r Survivorship: <br /> j;'•=°•i Signature: Date: <br /> NEW OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the sale or change <br /> of ownership.I understand that the home cannot be relocated without first completing this application and purchasing a trip permit <br /> from the Building Codes Division or through one of its county agents. <br /> I understand that the seller/owner is responsible for submitting this application within 30 days after the close of the sale,and that all <br /> buyers and sellers will be notified by mail when the application is approved.If the application has not been submitted after 30 days,I <br /> may complete the filing under ORS 446.64(1). <br /> I understand that each lessor,mortgagee,trust-deed beneficiary,lien holder of record,and security interest holder must be listed on <br /> this notice.If none are listed,the structure must be free and clear of all mortgages,deeds of trust,security interests,and liens. <br /> Page 3 <br />
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