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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />lamarogstorodbuilderOR( )thoauthodzedrepresentat~ve <br />of a registered builder. <br /> <br /> DALE; ZIP?/92 .[ME: 11:04:17 <br /> <br /> IUNCAN JANE L~ )OROTHY <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> DATE; <br /> <br /> 9033 SI'AYI'ON RD SE CONTRACT CITY. UGB: <br /> qUHSVILL. E P 97,525 HA~ION COUNTY ,m <br /> <br />USE OF BUILDING <br /> MANUFACTURED S~RUCTURE <br /> <br /> PHONE: ~9.- ] .'~45 V~LU~T~ON: <br /> <br />TAX LOT CATEGORY <br />413R5--000 RESIDENT IA <br /> <br /> OCCUPANT LOAD; <br /> <br />92~04363 <br /> <br /> 9S 2~ <br />~_98 aP <br /> <br />TYPE: MANUFACTURED STRUCTURE <br />CON~RACTOR~ NO. 14876 <br /> Ne$tern lying Homes iRC <br />4855 Portland Rd NE <br /> <br />PERMIT OR APPLICATION NO: 90446;57 <br /> <br /> I l'Ett <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED SI'RUCfURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br />MANUFACTURED STRUCTURE ZONING SURCH~RG~ <br /> <br />OUAN'I I 'FY <br /> <br />AMCRJHT <br /> $ ,I 82 ,, 00 <br /> $20. O0 <br /> <br /> $15, OO <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$226.1.0 <br /> $0.00 <br />$226.10 <br /> <br /> r-..... 8~LANCE DUE $O,,OG <br />PAYE~: DUNCAN' JAMES E & DORO"HY Y~%~ RECEIPT 4&7R~ <br /> ...... ................ ............. <br /> THIS ZS NOT A PERMIT. THIS APPLICATION MUST 60 THROUDH A RE¥IE~ PROCESS ~HERE THE <br />FOLLOWING MUST BE COMPLETED. IT ]S THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THA~ ALL NECESSARY :iNFORMATION NAS BEEN PRO¥IBED. <br /> <br />PL. ANN I N61 AC'T ION: <br />PLAN REVIEI~: 8Y DAI'E <br />ZONINS: BY DATE <br /> <br /> CITY ,]URISDICTIOH: 8Y DAVE <br /> <br />SETBACKS: <br /> <br />t.s <br /> s <br />RR,.~/Z,, ' <br /> <br />FORM # MC 15-58 REV. 4/90 OFFICE COPY <br /> <br /> <br />