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MARION COUNTY BUILDING INSPECTION SENATOR BLDG. NO, 225 220 HIGH STREET NE SALEM, OREGON 97301 PHONE: 588-5147 8:00 - 4:30 I am performing work on a property I own or occupy. ( Iofama registereda regisf~redbuilder.bUilder OR the authorized representative SIGNATURE OF A P P LIOA NT; (~¢.¢~,~ The work will be performed by a registered builder. Other I have read and agree to the terms stated on the reverse side of DATEZ th~S document. DATE: 10/14/92 TIHE: 11:12."59 TAX LOT: S~TUS nBBRESS: C0N~T~UdTtON TYPCi i O0OUPANOY: 18206 BUTTEVILLE RD NE : AURORA OR 97002 I~f~T¢0~T ~UN T Y USE 0¢ BUH~DIN~: ......................................... MANUFACTUREO STRUOTURE ~Alt_iNG ADDRESS'. PASCUAL V BRISENO ~ RENTER 98,L~7552 MSG 585-7036---" SITE NUMBER: TYPE: MANUFACTURED STRUCTURE PERMIT OR APPLICATION HO: CONTRACTOR, NO. UPPENOAHL, NOREEN PASCUAL V 8RISENO - RENTER 981-7~52 MSG 585~70~6 PHONE: IfEM HANU~ACTURED STRUCTURE ZONING SURCHARGE MANUFACTURED STRUCTURE STORAGE PERMIT TOTAL ~$SESSED FEES PREVIOUS RECEIPTS THIS RECEIPT '9045191 QUANTITY AMOUNT $t5_00 $25.00 $40.00 $0.00 $40.00 (~ BALANCE DUE $0.00 PAYEE: ANGLE N. SANOOVAL RECEIPT 45265 RECEIVED BY: OM2 ................................... TYPE: OK CHECK ~: 1902 · THIS iS MOT A PERMIT. THIS APPLICATION MUST ~0 THROUGH A REVIEW PROCESS NHERE THE FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE THAT ALL NECESSARY INFORMATION HAS BEEN PROVIDED. PLAN REVIEW: BY__,_~_,~/,~___ DATE ZONING: BY__~_~../~ .... DATE ........ Z_]_~ RSL_~ .... 6ITY JURISDICTION: BY OFFICE COPY FORM # MC 15~56 R~. 4/90