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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 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> The work will be performed by a registerod builder, <br /> Other_ <br /> <br /> this document. <br /> <br />S~TUS AOO~SS: ' <br /> <br /> ;f,;l, 65& F~LCON CT -_ , <br /> ~t..U;~ORA OF~ '¢78e2 ~ ~R~RcE~UNTY; u~pj {OCCUPANT ~OAD; <br /> <br /> CENTRURY <br /> LAKE 0SWE60. OR 9'7~35 SITE NUMBER: <br /> PHONE: 6~6-Ygli. 8 VALUATION: <br /> <br />TYPE.- MANUFACTURED STRUCTURE <br />CON'fRAC'f~R, ,NO, ,7~977 <br /> L, AHA.I N COI,IBTI:~UE, T I ON <br />206 SE 4TH <br /> <br />PHONE'.: 768-7736 <br /> <br />PERHIT OR APPLICATION NO: 45944 <br /> <br />btANUFACTURED STRUCI'URE F'LACEHENT/CONNECTIOIY <br />MANUFAC'~r'URE'O STRLICTURF.. STATE FlEE <br />~AI,IUFACTORED STRUCTURE STATE SURCt-.IAR(iIE <br />MAI,It. JF'AC'TLJREI) ~N'I:~LJC'I'URE Z[)I,IIN6 OURCHARGE <br /> <br />TOTAL_ ASSES,.~:.D FEES <br />. I',EVZOUo RECEIF'TS <br />THIS RFCEIPT <br /> <br />I~fAL,, AI',]C E DUE <br /> <br />QUANTITY AMOUNT <br /> $20,, ~0 <br /> <br /> $226., 10 <br /> $226.10 <br /> <br />$0,. 00 <br /> <br /> F'AYEE: <br /> RECE'tVED BY: F'i'I RIECEIF'T <br /> ........................................... ::==;;;;.".':::t===;;;;.~.:=:==;=_~=;;:;=:: ........................ 1 ~'1 L~ CHEEK ~j-. <br /> *A THIS IS ~ V'LID PERMIT ** THIS PERMIT FEE'"E E ........ ...... .................................................. <br /> PERMIT IS VALID FOR SIX MONTHS ONLY. RENEWED FOR 8 MONTHS UPON WRITTEN REQUEST FOR <br /> AN EXTENSION. PRIOR TO THE EXPIRATION DATE OF THE ~EMIT~ IF CONSTRUCTION F~ILS <br /> MEET ALL REQUIREMENTS OF STATE LAWS AND ~ARION COUNTY BUlLDiN~ ANg ZONING ORDiNANCES~ <br />F'LANN ~;N(; AO'T'I ON i'. <br /> OE'T'BACKS: F'R <br /> [_B""~ <br /> RS"'15 <br /> R R'"' 12 <br /> <br /> F~Ii:MARI<S: HF'G HOME <br /> <br />DONALD E.. [,IOOI)LI;.(., ~'iARtC!t,1 CE)UI,I'Y'Y ~U.d.,~].NF.,. OFFICI(4I_ / BY <br /> <br />~OnM, MC*~-t~ m~V..~ OFFICE COPY <br /> <br /> <br />