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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 />I 8m performing work on a property I ewrl O¢ OCCUpy, <br />l am a registered builder OR ( )theauthodzed representative <br /> <br />lhe work will be performed by a reDistered builder. <br /> <br />I have read and agree to the terms stated on the reverse aide of <br />this document. <br /> <br />OWNER; <br /> <br /> 106 ESSEX 9R <br />AUMSVIL, LE OR 97325 <br /> <br />TIME: 14:52:49 <br /> TAX LOT: CATEGORY; <br /> I RESIDENTIAL <br /> <br /> 2 0d~: , OCCUPANT Le~O: <br /> ~ AUMSVILLE NO : <br /> <br /> MANUFACTURED STRUCTURE ~ 3 <br /> <br /> MILL CREEK_ ESTATES <br /> AGENT; CRAIG LUCAS - SANTIAM HOMES <br /> SITE NUMBER.- ?3-83484 <br /> PHONE: 769-7744 ; VALUATION: <br /> <br />t. OT; ' BLOCK: SECTION: :TOWNSHIP: ' RANGE; M~P: <br /> S4 ' lee 5400. SF ' N0 ' N0 <br /> <br />TYPE: HANUFACTURED STRUCTURE <br />CONTRACTOR, NO. 38238 <br />Daoiel L Carver <br />11373 Mil). Creek Rd <br />A~Msvil).e, ~7~25-00~0 <br />PHONE: 7&~.-7744 <br /> <br />PERMIT OR APPLICATION NO: 50513 <br /> <br /> ITEM <br />MANUFACTIJRED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCNAR6E <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $182.88 <br /> $20.00 <br /> $9.10 <br /> <br />TOTAL ASSESSEB FEES $211.10 <br />PREVIOUS RECEIPTS $211.10 <br />THIS RECEIPT $0.00 <br /> <br /> $0.00 <br /> <br />REMARKS: MF6 HOME <br />~ONAL~ g. WOODLEY~ <br /> <br /> PAYEE: .' INVOICE <br /> RECEIVED BY: PB ..................... ,~2L___,, ....... TYPE: CNECK $: 0 <br /> <br /> tt THIS IS A VALID PERH~T tS THIS PERMIT FEE COVERS ONE INSPECTION AND ONE <br /> REINSPECTION. ALL DLOCKiNG~ STAIRIHSTALLATION~: PLUHBIHG~ MECHANICAL. AND ELECTRICAL <br /> CONNECTIONS ARE REOUIREDTOBE COHPLETED UPOHiREGUEST FORTHE F[RST IRSPECTIDH. ~F <br /> AHY OF THE ITEMS ARE INCOMPLETE. ANADDITIONAL INSPECTIONFEE ~ILL BE REOUIRED. <br /> PERMIT IS VALID FUR SIX MONTHS ONLY, REHEARD FDA &MONTHS UPON ~RITTEN REgUEST FOR <br /> AH EXTENSION. PRIOR TO THE EXPIRATIOHDATE OF TNEPERHIT. IF CDHSTRUCTIGN FAILS TS <br /> NEET ALL REgBIRENENT5 OF STATE LA~S AH~ HAR[ON COUNTY BUILDIHG AND ZONING OR~INANCES~ <br />PLANNING ACTION: <br /> SETBACKS: FR 11 <br /> LB-15 <br /> R$"'15 <br /> RE-10 <br /> SP~ <br /> <br /> MARION COUNTY ~UILDING OFFICIA~ / BY ......... ~_ ............... <br /> <br /> OFFICE COPY <br />FORM # MC 1 ~-~6 REV. 4/90 <br /> <br /> <br />