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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 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />Other <br /> <br />OAF(C: 10/29/91 '"'iME= 11:3'7':33 <br /> <br /> r"~,J LKNEN, Ar'4i L <br /> <br /> YEN C'1 <br />AUMSVI LLE OR 9'7325 <br /> <br />USE OF BUILDING <br />MAIl, lNG ADDRESS <br /> <br />MANUF'AC'T'UREO STRUCTURE <br /> <br />SrGNA'fURE OF APPLICANT: <br /> <br />DATE: <br /> <br /> TAX LOT <br /> <br /> CONSTRUCT ON TYPE <br /> <br />32 <br /> CONTRACT CITY <br /> <br /> AUMSVI LLE <br /> <br />SUBDIVISION: <br /> <br /> CATEGORY <br />5'??O~-0UU RESI DEN 1 LA <br /> <br /> 2CCUPANCY <br /> R- ."J <br /> JGE OCCUPANT LOAE <br /> <br /> NO OF BEDROOMS <br /> <br /> 2 <br /> <br />,~VERGREEN MOBILE ES/'AIF,5 <br /> <br /> ALBANY OR W't321 <br /> PHONE: 393-0041%. SI f'E NUI'4BER.' 14'7'13 <br /> VALUAT iON: <br /> <br />I CT' BLOCK' SECTION TOWNSHIP'. RANGE ' ~'0NE: <br /> 32 25 85 2W <br /> <br />WIDTH 55 DEPTH' 80 AREA: UN~TS: S~;;. IRREG LOT' Y,~ OORNER':'ON <br /> <br />TYPE: MANUFACTUREO S'['RUC'f'URE PERFIi'f' OR APPLICATION NO: 903~;428 <br /> <br />CONTRACTOR, NO. 38238 <br />Oanfe"l L Camven <br />]1373 Mi"l"l Creek Rd <br />Aumsvi"l"le, 9?325-0000 <br />~ONE: 769-7'F44 <br /> <br />MANUFACTURED STRUCTURE PLACEMEN'f/CONNEC'f'iON <br />MANUFACTURED STRUCTURE S'fAI'E FEE <br />MANUP~C'[URED S'F'RUC1URE 5f'A'FE SUF~,%~ARGE <br /> <br />TOTAL ASSESSED FEES <br />PRE¥iOUS RECEJP'f'S <br />THiS RECEIPT <br /> <br />QUANTITY <br /> <br />AMOLINi <br /> $182_00 <br /> <br />$o. 00 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: f.)anfie"l L Camver ~ iNVOICE :38359 <br />RECEIVED BY: F,"8 jj:j==..__.;===:,_.~ .......................................... ........ TYPE: iN CHECK ~: 0 <br />~ THiS i$ NOT A PEI~iT. THIS ACPLiCATiON NUST GO TH~ A R~i~'~ ~ERE THE FOLL~JN <br />~PLETED. iT IS THE R~SIBILiTY OFTHE APPLi~T TO ~RE THAT ALL N~ INFO~I'I <br />P~ViDED. <br /> <br />SEP'1'~C: 8Y ............................................ DA'r~ ................................................ C[TY JUR[SO[C'f~ON: 8Y 0A'I~! <br /> <br />ZONING: 8Y DATE SETBACKS: FR 10 LS 10 RS 10 RR 10 5P <br />RE;MARKS: fvDB'ZEE'"'RORE PLAC'ER'ERT .................................. <br /> <br />PLANNING ACIION: <br /> <br />OFFICE COPY <br /> <br /> <br />