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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 am performing work on a property I own or occupy. <br /> I am a registered builder OR the 8uthorized representative <br /> of a registered builder, <br /> The work wi[I be performe( by 8 eg s ered bu de <br /> Other <br /> I have read and agree to the terms stated on the reverse side of <br /> this document. <br /> <br /> f)ATE: :[0112193 TIME: <br />OWNER: <br /> SAN'r:rAM HOMES <br /> <br /> ~15 ASPEH DR <br />AUNSVILLE <br /> <br />S~GNATURE OF APPLICANTI <br /> <br />DATE; <br /> <br />USE OF BUILDING: <br /> MANUFACTURED STRUCTURE <br /> <br /> MILL CREEK ESTATES <br /> AGENT: CRA~G LUCAS <br /> SITE NUHBER: ~3-83470 <br /> PMONE: 76~-7744 VALUAT~Ofl: <br /> <br />iW OTR; :DEPTHi AREA ; UNITS: IRREG. LOT; , GORNER~ <br /> 1~2 60 t~720. : SF NO I NO <br /> <br />TYPE= HANUFACTURE~ STRUCTURE <br />CONTRACTOR~ NO. ~82~8 <br />Dan~.el L Carver <br />1137~ Mill Creek Rd <br />Aumsville. 77~25-0000 <br />PHONE: 769-7744 <br /> <br />PERHIT OR APPLICATIOH NO: 58483 <br /> <br />MANUFACTURED STRUCTURE PLACENENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />NANUFACTUBED STRUCTURE STATE SURCHARGE <br /> <br />PAYEE: <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $182.00 <br /> $20~00 <br /> <br />TOTAL ASSESSEB FEES $211.10 <br />PREVIOUS RECEIPTS $211.10 <br />THIS RECEIPT $0.~0 <br /> <br />BALANCE CUE <br /> <br />INVOICE <br /> <br /> RECEIVED BY: PB ................................... TYPE: CHECK ¢: 0 <br /> <br /> · ~ THIS IS A VALI~ PERNIT ~$ THIS PERHIT FEE COVERS ONE INSPECTION AND ONE <br /> '. REINSPECTIGH. ALL BLOCKING, STAIR' INSTALLATION. PLUNB[NG~ HECHANICAL. AND ELECTRICAL <br />,, CONNECT[OHS ARE REGUIRED TO SE COHPLETED UPON REGUEST FOR THE FIRST INSPECTION. iF <br />· ',. AHY OF THE [TENS ARE IHCONPLETE. AH AODITIOHAL [HS~ECTiON FEE BILL SE REOUIRED. <br /> PERHIT IS VALID FOR SIX NOHTHS ONLY. REHENE9 FOR 6 HONTHS UPOH ~RITTEN REOUEST FOR <br /> AH EXTEHSIUN. PR[OR TO THE EXPIRATION DATE OF THE PERHIT. IF COHSTRUCT[ON FAILS TO <br />~ HEET ALL REOUIREHENTS OF STATE LA~S AHD ~ARION COUHTY BUILD[H§ AH9 ZONING OROIHAHCES~ <br /> PLANNING ACTION: <br /> SETBACKS: FR 11 <br /> LS-15 <br /> RS"15 <br /> RR-10 <br /> REMARKS: MFG HOME SP~ .... <br /> DONALD ~. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. 4/90 <br /> <br /> <br />