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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97;301 <br /> <br /> PHONE: 588~5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on a property I own or occupy. <br />I am a registered builder OR the authorized repre~enta ive <br /> of a registered builder, <br />The work will be performed by a registered buiFder. <br />Other. <br /> <br />SIGNATURE OF APPLICANT. <br /> DATE: <br /> <br />OWN£R: DATE: 10/B8/93 <br /> <br /> HUDNELL~ MICHAEL <br />S~TdS ACIDNESS: <br /> <br />TIME: <br /> <br />CA'rEGOR <br /> <br /> RES I gEN11 AL, <br />OCCUPANCY: <br /> <br /> 311 ASPEN DR -- 5 'CONTRACT CITY <br />AUMSVILLE OR 97325 AUMSVILLE <br /> <br />MANIJFACTURED STRUCTURE <br /> <br />UGB <br /> <br />EOT: <br /> <br />AGENT: CRAIG LUCAS/SANTIAM HOMES <br />PHONE: 585-8227 <br /> <br />~ILL CREEK. ESTATES MH PARK <br /> <br /> S~TE NUMBER: 9~-03§85 <br /> VALUATION: <br /> <br /> A~L~j U'f~i~'¢8''' .R~. LCT'. <br />......................................... Nfl .......... <br /> <br />CORNER <br /> <br />¸51 <br /> <br />TYPE: MANUFACTURED STRUCTURE PERMIT OR APPLICATION ~0: <br />CONTRACTOR~ NO. 20799 <br /> ~CMIHNVILt. E FACTORY HOMES thio <br />2050 S MWY 99 W <br />MCHINNVIL. LE~ 97128-0888 <br />PHOME: 9&7-8555 <br /> <br /> ~TEH <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURE~ STRUCTURE STATE FEE <br />NANUFACTURE~ STRUCTURE STATE SURCHARGE <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> $9. I0 <br /> <br />$211¢10 <br />$211.10 <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: MOMINNVILL. E FACTORY: HOHES ;INC INVOICE '~"~¢~9~5= <br />RECEIVED BY: PH TYPE: IN CHECK ~: 0 <br />* THIS iS HOT A PERHIT. THiS APPLZCATIOH HUST GO:THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST SE COHPLETED. ITiSTUE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THaT ALL HECESS~RY ZHFORMATZOHHAS BEEH PROVIDED. <br /> <br />PLANNING ACTION: <br /> PLAN REVIEW: BY_._~__ DATE_I~ ~11~..'~ <br /> ZONING: BY ......... DATE <br /> SEPTIC: BY ................. DATE .............. <br /> <br /> CITY JIJRISDICT'ION: BY DATE ........... <br /> REMARKS: MSu CARPORT <br /> <br />SETBACKS: <br /> <br />FR 11 <br />LS-i~ <br />RS-15 <br />RR-10 <br />SP~ ......... <br /> <br />FORM # MC 1 d-56 REV, 4190 OF FIOE COPY <br /> <br /> <br />