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MARION COUNTY BUILDING INSPECTION <br />SENATORBLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4'.30 <br />24 HOUR CODE-A-PHONE:: 588-7904 <br /> <br />of a registered budder <br /> <br />Ct h~,r <br /> <br />I have read end agree to the terms stated on the referee side of <br /> <br /> DA]E: 12/18/90 ~IME: 8:49:28 <br />OWNS, R TAX LOT <br /> <br /> 109~8 SlM~ RD ~ CONTRACT CITY UGB <br /> ~&V t LLE OR 97325 <br /> ~RJ~ ~NFY NO <br /> <br />USE OF BUILDING <br /> <br /> fEAME <br /> <br /> PHGNP:: 749=2459 SlIE NUI~ER: <br /> VALUATION: <br />LOTBLOCK S~CTION TOWN~HIP RANGE <br /> 20 8$ 1W <br /> 5. ~ NO <br /> <br />CATEGORY <br /> RE~ I D~N 1 AL <br />OCCUPANCY <br /> <br />OCCUPANT LOAD <br /> <br /> N0 OF ~IEDR00M5 <br /> <br /> 2 <br /> <br /> 11922 <br /> <br />ZONE MAp <br /> <br /> RA 48 <br />CORNER <br /> NO <br /> <br />FYPI:: NOBILE HOME <br /> <br />CONf RAC fOR, NO. <br />ROBEH rS, VANCE <br /> <br />P'HON ~: 749--2459 <br /> <br />PERMI1 OR APPLiCA]ION NO: <br /> <br /> I 'fEN <br />MOBILE HOME ADDIL. FEIP.,I~ <br />fCCDBiLE HOME ZONING SURCHARGE <br />FLEEr SUR(.,'HARGE -ZONE 3 <br /> <br />29264 <br /> <br />IOTAL A~JSE,TS.~ED FEES <br />PR~i(~JS RECEIPT'S <br />THIS RECEIPT <br /> <br />A,'~OUNI <br /> $25.00 <br /> [1.25 <br /> 3.84 <br /> <br />~30.09 <br /> 30,09 <br /> $o.o0 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYES: RECEIPt <br /> <br />* THIS IS A VALID PER~IT m THIS PER, IT E~PIR~ 180 DAY~ FRO~I ITS I,%.~E DATE. IF <br />CONSTRUCTION CEASES FOR A PERIOD OF 180 [:)AYS,OR IF COI%.~TRUCTION FAiL~ TO MEET ALL <br />REQUIREMENIS OF STATE ~ AND le/ARION COUNTY BUILDING AND ZONING ORDINANCES, THIS PER~4IT <br />.~3HALL BECOtv~ NULL AND VOID. <br /> <br />SE'f~ACK,~.~ PR 20 L,~ 10 R~5 10 RR 30 E~P ........ <br />RE.~4ARK,~: MC~ILE HO~vlE S[ORA~E ~At3432 <br /> <br />PL4~NING ACTION: <br />DONALD E. WOOOLEY, f.IARiON COUNTY BUILDING OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />