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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 />of a registered builder. <br /> <br />I have read and a0reo to the terms stated on the reverse side of <br />this document. <br /> <br />o~/~'~: 0?/26/$8 TIME: 3: 50.- 22p ', fX× LS~i /'8~¥[86&,a <br /> LINDLEY, ~A~E ~ 0~019-000 ~ ~ESI OENTIAL <br /> <br />SAME <br />PHONE: <br />LOt: BLOOK: <br /> <br /> 14 <br />WFOTH' IDEPT~i <br /> <br />VI LLAGE VIE~ <br /> <br /> SITE NUMBER: <br /> VAUJATION: <br />isECfJ~: .... !~GWNSMIp:' 'RANGE: <br /> <br /> 1.8 8S 2N <br /> 2.50000 : AC NO <br /> <br />:CORNER: <br /> <br /> NO <br /> <br />TYPE: MOBILE HOME <br /> <br />CONTRACTOR, NO. 38238 <br />SANTIAM VALLEY HOME;S <br />11373 MILLCREEK RD SE <br />AUIv~VILLE OR 97325 <br />PHONE: <br /> <br />PERMIT OR APPLICATION NO: (~gl~ <br /> <br /> ITEM <br />NOBILE HOME FIRST WIDTH <br />MOBILE HOf4E ADDTL. WIDTH <br />MOBILE HO~E ZONING E&,IRCHARGE <br />FLEET SURCHARGE -ZONE 3 <br />MOBILE HOME STATE SURCHAR'~E <br /> <br />PAYEE: <br />RECEIVED BY: J8 <br /> <br />QUANTITY AMOUNT <br />1 $35.00 <br />1 $15.00 <br /> ~2.50 <br /> 3.84 <br /> $2.50 <br /> <br /> TOTAL ASE~ESSED FEES $58.84 <br />' PREVIOUS RECEIPTS $58.84 <br /> THIS RECEIPT $0.00 <br /> <br />BALANCE DUE $0.00 <br /> <br /> RECEIPT NO: <br />TYPE: CHECK <br /> <br />~ THIS IS A VALID PER,lIT * THZs'P~ZTEx~R~ ~8oDAys FROM [TS ISSUE DATE. <br />OONSTRUCT~ON CEASES FOR A PERIOBOF180DAYS,OR ZFCONSTRUCTZON FAILS TOM EET ALL <br />SHALLREQI"IZRENENTSBECOf,4E NuLLOF STATE~LA~[DAND'=.IKAR[ONAND i 6OUNTYBU[LD[NGAND ZONING ORD[N.N~ICES, TH~S PER~[T <br /> <br />APPROVAL FOR ONE DWELLING UNIT ON PROPERTY ONLY. <br /> <br />REMARKS; REPLACE EXISTING MO BOME R~¢4 <br />PLANNING ACTION; <br /> <br />DONALD E. ~OODLEY, MARION COUNTY BUILDIN6 OFFICIAL / 8Y <br /> <br />FORM 't MC '5'56 REV. ~7 OFFICE COPY <br /> <br /> <br />