Laserfiche WebLink
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 />bmpe o m ngworkonaPopertylownor occupy. <br />I am a registered builder OR ( ) the authorized representative SIGNATURE OF AP LICANT; <br />cbf ~ rw%gr~twe,'l~ eb ~:dr fe'or;rf~ed by , r e0 ,,t e" ' ' red build e r. /'" <br />O,h,r. o,,6: / / <br />I have read afl~ agree tO the termG stated on the reverse side of <br />this document. <br /> <br />OATE: 10/21/92 TIME: 15:59:5] <br />GREEN, 30E RESIOENT[AL <br /> <br /> 11687 FALCON CT NE 33 CONTRACTOIT~ UGE OOCURANT&OAD: <br /> AURORA OR 97002 HARION COUNTY NO <br /> <br />USE OF ~UILD~NG; <br /> MANUFACTURED STRUCTURE <br />' ~AtL)NG ADDRESS~ <br /> <br />PO 80X 759 <br />PORTLAND 97207 <br />PHONE: 685-9685 <br /> <br />SUBDIVISION: <br /> <br /> CENTURY MEADOWS <br /> <br /> SITE NUMBER: 92-05754 <br /> VALUATION: <br /> <br />LOT: <br /> <br />WIDTH: <br /> <br /> OE~TH: AREA. UNITS' ~REG LOT <br />40 11o SF YES <br /> <br />RA <br /> <br />NO <br /> <br />MAP <br /> <br /> 1 <br /> <br />TYPE: MANUFRCTUREO STRUCTURE <br />CONTRACTOR, NO. 75977 <br /> LAMAIN CONSTRUCTION <br />206 SE 4TH <br />TROUTDALE~ 97060~0000 <br />PHONE: 760-7736 <br /> <br />PERHIT OR APPLICATION NO: <br /> <br />ITEH <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br />HANUFACTURED STRUCTURE ZONING SURCHARGE <br /> <br />FORM # MC 1 ~-56 REV, 4/9o <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />9045353 <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> $9.10 <br /> $15.00 <br /> <br />¢226.10 <br /> $0.00 <br />$226.10 <br /> <br /> BALANCE DUE $0.00 <br /> <br />RECEIVED BY." DM2 .......... ]~_~..~ _ ..~j TYPE: CK CHECK ~: 1132 <br /> <br />· THIS I8 NOT A PERMIT. THIS RPPLICATIOfl MUST 60 THROUSH A REVIEW PROCESS ~HEEE THE <br />FOLLOWING MUST BE COHPLETED; IT IS THE RESPONSIBILITY O~ THE ~PP~[CRNT .TO ASSURE <br />THAT ALL NECESSARY INF~RHATION HAS BEEN PROVIOEO. ~ ~~* ~ ~ ' ~ '% <br /> <br />SEPTIC: BY .......... DATE. - RS _~ <br />CITY JURISDICTION: BY___ n~.= ~o-- - <br /> <br /> ...... ~L~-,%,-¢~ ~. r'~ <br /> <br /> <br />