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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 />of a registered builder. . <br />The work will be performed by a registt~red builder, <br />Other. <br /> <br />this document, <br /> <br />..WNJ~t~.'I-E...: 04/0~'/92 1: INE: , 13,: 03: 34 <br /> <br /> POTHETES, NiCK <br />~rr0s ADDreSS; <br /> <br /> 270 EVERGREEN DR <br /> AUIVL%Vi LLE OR 9?325 <br /> ' AUr4svI,LLE i <br />:USE OF BUILDING; <br /> <br />~AX t_O~: CATEGORY: <br /> 57706-000 RE$I DENT 1AL <br />CONSTRUCTI© N TYp~; OCCUPANCY: <br /> <br /> R- 3 <br />CONTRACT CITY: : UGB~ :OCCUPANT LOAO; <br /> <br />'M~iFCh~ Ab~R~Sl r4ANU FAC TU RED $ T RUC']'U RE : sU~61vl~6N': <br />EVE~REEN £S]'A]'ES MH PARK <br /> <br /> PHONEs SiTE NUiVBER: 92-01389 <br /> , VALUAI'ION: <br />;LOT: :8[0OK: :SECTION: ' :~dWN'SNIP:' ; R~NGE: zoNEi MAP: <br /> <br />!~ID~i,h ' iDE~N: ; AREA: UNITS: IRREG· t, OT: CORNER: <br /> 58 85~ SP' YES NO <br /> <br />'rYPE: 1"4ANUFAC'I'UREB STRUCTURE PERtflI'r OR APPLICATION NO: 9039208 <br /> <br />cONrRACTOR, NO. 38238 <br /> <br />11373 Mff-I-I Cheek Rd <br />Aumsvff'l]e, 97325-0000 <br />PHONE: 769~7'744 <br /> <br />[VlANUFAC'rURBD STRUCTURE PLACENPJN'I'/OONN£C'I'ION <br />MANUFACTURED STRUCTURE STATE FEE <br />NANUPAC1'URED STRUCTURE STATE ~i~URr-..,T'IARGE <br /> <br />TOTAL A.SS~EO F'B£S <br />PRE¥IOUS RECBIP'r8 <br />THiS RECEIPT <br /> <br />QUANTITY <br /> <br />AI~OUN'I <br /> <br /> $20.00 <br /> $9.1o <br /> <br />$211_10 <br /> $0.00 <br />$211.1o <br /> <br />BALANCE E.X,J B $0.00 <br /> <br />PAYEE= CRAIG LUCA8 /~ iNVOiCE 41234 <br />RECEIVED BY-. PB ~ TYPE* IN C~ECK ~-, .... <br /> 0 <br /> THiS IS NOT A PEI~IiT. THiS APPLiCAT[ON I~IUST 60 THROUGH A REVIEW PROCE,.%.% ~[HERE THE FOLLOWi~ <br />NIUST BE CO¢4PLETED. [T IS THE RESPONSiBILiTY OF THE APPLICANT TO AEx..'3URE THAT ALL NECE~;xARY <br />iNFOF~IATION H~.%BEEN PROVIDED. <br /> <br />SEPTIC: BY DATE CiTY JURiSBiC'f'iON~ BY DATE <br /> <br />ZONING: BY DATE SETBACKS: ~R 10 L$ 15 ~ 15 RR 10 ~P <br />REr4ARKS: ~JB['EE-ROf~IE PLACERENT ................................ <br /> <br />PLANNING ACTION: <br /> <br /> OFFICE COPY <br />FORM # MC 15,56 REV. 4/90 <br /> <br /> <br />