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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 />I am 8 registered builder OR the authorized representative SIGNATURE OF A~PLICAN <br />of a registered bui,der, <br /> <br /> The work will be performed by a registered bdilder'. <br /> Other,. <br /> <br />OA'rE: o6/t9/9'2 'r:[ME: 1.5.*~8;14 <br /> <br /> E~ARBEE. DiCK ~ GRACE <br /> <br /> 20772 OLM~'rEAD RD NE <br />AURORA OR 97002 <br /> <br />CON$TRUCTION TYPE: <br /> <br />' MAILING <br /> <br />t'~IANU.FAC;r,u RI~O ...8'i: PUC TU RE .......... <br /> <br />CONTRACT CITY UGB <br />MARION OOUN I'Y NO <br /> <br />SU PDtVISION. <br /> <br /> PHONE: 678~5687 SITE NU~ER: 92-02310 <br /> VALUAT <br />t~df: B[-(~CR SECflON TOWNSHIP RANGE'. ZONE MAP'. <br /> <br /> 18 ~,~ 1W EFU 4 <br />WIDTH; ~DEPTR <br /> 12. ? 5 AC NO NO <br /> <br />TYPE: MANUFACTURED STRUCTURE PERMIT OR APPLICATION NO: 904076? <br /> <br />eoN'tRACTOR, NO. <br />F3Ar..~EE, DICK ~ GRACE <br />SAME <br /> <br />PHONE: 678-5667 <br /> <br />M/~IUFACTURED STRUCTURE PLACP. TVlENT/CONNECTioN <br />D1ANUFAC'fURED ~TRtJCTURE STATE FEE <br />MANUFACTURED ~TRUC'rURE STATE E~RCHAR~E <br />MANUFACTURED ~TRtJCTUR£ ZONING SURCHARGE <br /> <br />TO?AL ASS~ED FEES <br />PREViGLISRECEiPTS <br />THiS RECEIPT <br /> <br />QUANTI'I'Y <br /> <br />$~82.00 <br />$20.00 <br /> <br /> $15,00 <br /> <br />$226.10 <br /> $o.oo <br />$226.10 <br /> <br />BALANCE BUE <br /> <br />PAYEE: BARSEE, 0~,C~ & ~E RgCEiP'f' 42795 <br />RECEiVED~~,{ ¢%%.---~~' "~----.,~ : : TYPE: :CK ~ECK"' ,: 1526 <br /> <br />SEPTIC: BY DATE .................................. CiTY JURi$°IC'rION: BY ................. DATE ............................ <br />ZONING: BY""~'---[7~i:E E'¢"2¢'~' ~E'f'BACI4.S: FR ~ L$ ~ RS,,,~¢~.. .......... RR.,~.. $P ................... <br />REI~,IARKS: M~--PE. ACERENr NO-'ADI~'~T'~0NAL BEDROOMS NO--CEOSE'rs ............... <br /> <br />OFFICE COPY <br /> <br /> <br />