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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 />of ~ registered builder, <br />The work will be performed by a registered builder, <br />Other. <br /> <br /> I ha¥o read and ASree to the terms stated on the reverse side of <br /> this document, <br /> <br />,OwNEm; SANTIAM HOMES <br /> <br />~AX LOT: I c,,,~ENT I A L <br /> <br /> ESSEX DR <br />AUHSVILLE <br /> <br />OR <br /> <br />97;~25 ~ ~lCt~ i;.ilr~ U~:I OCCUPANT LOAO: <br /> <br />USE oF BU,LDi~NtJFAOTURED STROcfoRE <br /> <br />AGENT: CRAIG LUCAS - SANTIAM HOMES <br /> SITE HUHBER: ?3-83484 <br />PHONE: 769-7744 VALUATION: <br /> <br />:LOT: BLOCK: ~E~'ribN; ...........................................: TOWNSHIP: RANGE: ZONE: MAR: <br /> 2 <br /> <br /> WIDTH: 54 )DEPTH; '11~1~ , AREA; ,.~4~1. ; UNITC~F IRit.~. LO't: i CORNf~: <br /> <br />TYPE= MANUFACTURED STRUCTURE <br />CONTRACTOR, HO,, 38238 <br />Dan£el L Carver <br />11~7~ Mill Creek Rd <br />~umsville~ 97~25~8008 <br />FHONE: 7&e-7744 <br /> <br />PERHIT OR APPLICATIOH HO: 90§0513 <br /> <br />ITEM <br />MANUFAOTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED ~TRUCTURE STATE SURCHARGE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $182.00 <br /> $28.00 <br /> $9.10 <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />$211.18 <br /> $0,00 <br />$211.10 <br /> <br />  BALANCEDUE $0.00 <br /> <br />PAYEE: Del McCormick INVOICE 52D08 <br />RECEIVED BY: DM2 ................................. TYPE: IN CHECK ~: 0 <br />$ THIS IS MOT A PERMIT. THIS APPL[CATIoNHusT GOTHRoUgH A REVIEM PROCESS WHERE THE <br />FOLLOWING HUST ~E COMPLETED. IT ISTHE RESPOHS[BILiTY OF THE APPL[CAHT TO ASSURE <br />THAT ALL HECESSARY IHFORMAT[OH HAS 8EENPROVI~ED. <br /> <br />PLANNING ACTIOH: <br /> PLAN REVIEW: BY ~ DATE lo'q- h <br /> ZONING: BY .......... DATE .......... <br /> SEPTIC: BY ................ DATE ............. <br /> <br /> CITY JURISDICTION: BY DATE . <br /> REMARKS: NFO HOME <br /> <br />SETBACKS: FR 11 <br /> LS"15 <br /> RS-l§ <br /> PR-lB <br /> sP:___ <br /> <br />'ORM # MC 15,56 REV, 4/90 <br /> <br /> <br />