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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:SO <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> lamaregisteredbutlderOR( )theauthori~edrepresentative <br /> <br /> The work Will be performed by a registered builder, <br /> Other. <br /> <br /> this document, <br /> DATE: 09/22/92 TIME: i2:45:29 <br />~OWN~R,. <br /> PEERY, GREGORY & DEBORAH I /.J4u-llO <br /> <br /> 11585 BUNTING LANE NE <br /> AURORA OR 97002 ~R~UNTY <br /> <br /> CENTURY <br /> <br /> S[TE HUHBER: <br /> PHONE: 678~2358 V~LU~T~ON: <br /> <br />TYPE: HANUFACTURED STRUCTURE PERNIT OR APPLICATION NO: <br />CONTRACTOR~ <br />PEERY, GREGORY & OEBORAH <br /> <br />9042732 <br /> <br />PHONE: 678-2358 <br /> <br /> ITEM <br />MANUFACTUREO STRUCTURE PLACEMENT/CONNECTION <br />NANUFACTUREO STRUCTURE STATE FEE <br />HANUFAGTUREO STRUCTURE STATE SURCHARGE <br />NANUFACTUREO STRUCTURE ZONING SURCHARGE <br /> <br />PAYEE: PEERY, GREGORY & DEBORAH <br />RECEIVED 8Y: PM <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />ANOUNT <br /> $182.00 <br /> $20.00 <br /> $9.10 <br /> <br />$226.10 <br /> $o.oo <br />$226.10 <br /> <br />BALANCE DUE $0.00 <br /> <br />RECEIPT 44790 <br /> <br /> TYPE: CK CHECK ~: 2126 <br /> <br />* THIS IS NOT A PERMIT. THIS APPLICATION MUST 80THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THAT ALL NECESSARY IHFORNATION HAS BEEN PROVIDEO. <br /> <br />PLANNING ACTION: <br /> ZONING: BY ,~._~..-'Z <br /> <br /> CITY JURISDICTION: BY .............. DATE ........... <br /> REMARKS: <br /> <br />SETBACKS: <br /> <br />LS ~ <br />R sZ .T -Z <br /> <br />FORM # MC 15-56 REV. 4/90 OFFICE COPY <br /> <br /> <br />