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~F ' 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 pedormed by a registered builder. <br /> Other <br /> <br /> this document, <br /> <br /> DATE: 09/29/92 TINE: 9:24:04 <br /> <br /> SITUS AODRESS: <br /> <br /> 9784 HILL CREEK R~ <br /> <br />us[orBUL~UFACTURE0 STRUCTURE <br /> <br /> 9804 HILL CREEK RD SE <br /> ~UHSV~LLE, OR SITE NUMBER= ~2-0~253 <br /> PHONE: 749-2405 <br /> <br /> TYPE: MANUFACTUREO STRUCTURE PERMIT OR APPLICATION MO: 42505 <br /> CONTRACTOR~ NO. <br /> KLEIN, LARRY <br /> 9804 MILL CREEK RD SE <br /> AUHSVILLE, OR <br /> PHONE: 749-2405 <br /> <br /> ITEH QUANTITY AMOUNT <br /> MANUFACTURED STRUCTURE PLACEMENT/CONNECTiON $182~00 <br /> MANUFACTURED STRUCTURE STATE FEE $20.00 <br /> NANUFACTUREO STRUCTURE STATE SURCHARGE : <br /> HANUFACTUREO STRUCTURE ZONING SURCHARGE : <br /> <br /> $226.10 <br /> THIS ~ECEI'P7 $0.00 <br /> BALANCE DUE $0.00 <br /> <br /> PAYEE: :: RECEIPT <br /> RECEIVED BY: PB T ; CHECK ~ 0 <br /> *~ THIS IS A VALID PERMIT: ~ THiS PE:RM~T:FEE:COVERS ONE INSPECTION AND ONE <br /> REINSPECTION. ALL MECHANICAL. AND ELECTRICAL <br /> CONNECTIONS ARE REOUIREDhTO;BE~OflPEE'~ED,UPONREDUES% FORTHE FIRST INSPECTION. <br /> ANY OF THE ITEMS ARE N[LL BE REQUIRED. <br /> PERMIT IS VALID FOR -~ UPON ~RITTEN REOUEST FOR <br />AN EXTENSION. PRIOR TO THE :EXP~RATION:DAYE:.OF'TRE PERMIT%' IF CONSTRUCTION FALLS TO <br />MEET ALL REQUIREHENTS OF:STATE:LAWS AND:RANI'ON cOUNTY BUiED%NG AND ZONING ORDINANCES, <br />PLANNING ACTION: <br /> SETBACKS: FR 20 <br /> :!: LS~iO <br /> RSZiO <br /> RR <br /> <br /> REMARKS: NFG HOSP <br />DONALO E. WOODLEY, MARION COUNTY BUILDIN'G OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />