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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 />Other. <br /> <br />I have read and asree to the terms stated on the reverse side of <br /> <br />o~T~: 06/17/88 TIME: 9:5t:03a <br /> CHAPNESKE, N_J. & GERTRUDE <br />SITUS ADDRESS: <br /> <br /> 9684 SILVER FALLS H~¥ <br />AUMSVILLE OR <br /> <br />9?325 <br /> <br />SE <br /> <br /> TAX LOT. <br /> <br /> CONSTRUCTION TYPE <br /> <br />CONTRACT CITY: JGS: <br />~iAR 1' ON CO~JNT¥ .... NO <br /> <br />i~A~EGORY; <br /> RESi 0EN'FIAI... <br /> <br />iOOCGPANT LOAD: <br /> <br />MAILJNG ADDRESS: <br /> <br />SUBDtVISIQN: <br /> <br />SAME <br />PH ON E: <br />LOI BLOCK SECTION <br /> <br />W~0TH' DEPTH AR~A <br /> <br /> SiTE NUMBER: <br /> VALUATION: <br />TOWNSHIP; RANGE <br /> <br /> UNITS RREG, ~OT: <br /> NO <br /> <br />ZONE MAP; <br />....... AR3 48 <br />NO <br /> <br />TYPE: MOBILE HOHE <br /> <br />CDN]RACTOR, NO. 38238 <br />SANTIAM VALLEY HOMES <br />11373 IqlLLCREEK RD SE <br />AUMSVILLE OR 97325 <br /> <br />PERMIT OR APPLICATION NO; ~ <br /> <br /> ITEM <br />MOBILE HOME FIRST NIDTFi <br />~OBILE HOME ADOTL. NIOTH <br />MOBILE HOME ZONING SURCHARGE <br />FLEET SURCHARGE -ZONE 3 <br />HOSILE HOME STATE SU~HARGE <br /> <br />TOTAL ASSESSE0 FEES <br />PRECIOUS RECEIPTS <br />THIS RECEIPT <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 /> 58.84 <br /> $0_08 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE; RECEIPT NO: <br />RECEIVED BY: dB TYPE: CHECK <br /> <br />* T~IS IS A VALID PE~4IT · THIS PE~IT EXPIRES 180 DAYS FRO~4 TTS ISSUE DATE_ IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 DAYS~OR IF CONSTRUCTION FAILS TO MEET ALL <br />REQUIREMENTS OF STATE LA~ ¢~4D MARION COUNTY BUILDING AND ,ZONING ORDINANCES. THIS PERNIT <br />SHALL BECOME NULL AND VOID. <br /> <br />0~qALE E. WOODLEY, MARION COUNTY BUILDING OFFiCIAl_ / BY <br /> <br />rO~M ,, MC 15-56 REV 6/G7 OFFICE COPY <br /> <br /> <br />