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MARION COUNTY BUILDING INSPECTION <br /> SENATOR I~LOG, 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 />I am performing work on a property I owr) o( occupy. <br /> <br /> DATE: 12/17/9! 'r.I, NE: 12:27'-'20 <br />OWNER: <br /> ~RO~N , VICKIE <br /> <br /> 34,5 ~¥ER-'GREEN DR <br />AUNI~V J; LLE <br /> <br />OR 9?325 <br /> <br />TAX LOT: <br /> 5??0'5-000 <br /> <br />CONTRACT CITY: UGB: <br />AU~V].LLE NO <br /> <br />CATEGORY: <br /> RESIDgN ~ <br />CCC. LIP ANCY: <br /> <br />OCCUPANT LOAD: <br /> <br />MAILING ADORESS: I~NUFACTURED S'¥RUC'f'URE SUBDIVISION: <br /> <br />3 <br /> <br />EVERGREEN MOB,[LE PARK <br /> <br /> PHf.2C4E: ~5,t 'f' ~ NUIVt8 ER: <br /> VALUAT tON: <br />LO": BLOCK: SECTION: TOWNSHIP; RANGE: ZONE: <br /> <br /> 25 8¢ 2N RM <br /> <br />MAP: <br /> <br />[YPE: r4ANUFAC'rURED STRUCTURE PERfl'~i f' OR APPLICA'I'ION NO.* 903742t5 <br /> <br />CON[RAC'I'OR, NQ. 38238 <br />Danffe"l L <br />11373 ~ff'i"l Cheek Rd <br />Aum~vff"l"le, 9'7325~00D0 <br />F~ONg: '~9-,,,'/7~ <br /> <br />QUAN'f'I'I'Y <br /> <br />AROUNI <br /> $182_00 <br /> $20.00 <br /> $9_~0 <br /> <br />TOI'AL ArSSE~EO FEES <br />CREVIOU~ RECEIPTS <br />'~'Hi~ RECEiP'I' <br /> <br />$211.10 <br /> $0_ 00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: Oanie'l L Oamvcn ~ iN¥OiCE 39390 <br />-----------~-~RECEiVED-BY:-F~--====::-':s;:'==~==:;:~:::::~'~'~-":===; ...... TYP~: 1N CHECK ~: 0 <br /> <br />~ THiS iS NOT A PERfflIT. THIS APPLICATiON fVLJ~T 60 THROU6~i A R~i~ P~ ~ERE ~HE FOLL~iN <br />~T BE ~PLETED+ IT 1~ THE R~[B[L[TY OF THE APPLi~T TO ~RE THAT ALL NEC~RY <br />JNFO~T[~ H~ BE~ P~V[OED. <br /> <br /> .......~ ~ ........... DATE l~--t2-- _<~ i <br />PLAN R~WEW~ BY -- ................................. <br /> <br />5EP'i'iC; 8Y ............................................. DATe ...................................................... ~I'TY 5UR~SDtCTION: BY .............................. DAI'E ................. <br /> <br />ZONING: BY DATE SE'[SACKS: F'R 10 LS 15 M 15 RR 10 SP ................ <br />REIVlARKS: NIOBi'EE'"'RORE PLACE~ERT ........... <br /> <br />PLANNING ACTION: <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. <br /> <br /> <br />