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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br /> CODE-A-PHONE 4:30 P,M. - 8:00 A.M, <br /> <br />I am a registered builder OH ( )the authorized representative SIGNATURE OF <br />Other <br /> <br />11/04/97 <br /> <br />LUTZ, STARR <br /> <br />R <br /> <br /> 8898 SHERMAN RD SE <br /> AUfcCSV I LLE OR 9?325 I ~ <br /> .................................. ::"-'~R, ON' O6~JNTY'' NO .... <br /> <br /> . ',,,. <br /> <br /> PHONE: 749~-2189 SITE NUMBER; 3023 <br /> { VALUATIQB <br />'LOT: 91_OCK: SEctION: TO~VNSHIP: ' RANGE: } Z6~: <br /> <br /> 20 r 8S ..... ; ~.W '~ EFU <br />iAREA: :UNITS: , IRREG, LOT: CORNER: <br /> <br />MAP: <br /> <br />TYPE: MO~ILE HOME <br /> <br />CONTRACTOR. NO. <br />LuTZ, STARR E <br />SAME <br /> <br />PHONE: 749-2169 <br /> <br />PERMIT OR APPLICAT[ON NO: 9005385 <br /> <br /> ITF~ <br />PI38~LE HC~4E FIRST WIDTH <br />MOBILE HONE ADDTL. WIDTH <br />/V~LE HOME ZONING SURCHARGE <br />FLEET SURCHARGE -ZONE 3 <br />MOBILE HONE STATE .SURCHARGE <br /> <br />QUANTITY AMOUNT <br />1 $35.00 <br />1 $15_00 <br /> $2.50 <br /> $3.84 <br /> $2.50 <br /> <br />$58.84 <br /> <br />$58.S4 <br /> <br />$0_00 <br /> <br />PAYEE: LUTZ, STARR E .., ,. . RECEIPT NO: 5950 <br /> <br />FOLLONTNG MUST BE COI~PLETED. [T ]:S THE ,. :RI~2N~B':[I;~TY OF :THE APPLTCANT TO A.~JRE T~AT <br /> <br />REMARKS: 1~4'fq. ~EPLACEMENT ' <br />~>LANN~NG ACT,ON: <br /> <br />OFFICE COPY <br /> <br /> <br />