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MARION COUNTY BUILDING INSPECTION <br /> <br />SENATOR BLDG, NO, 22.5 <br />220 HIGH STREET NE <br />SALEM, OR6GON 97301 <br /> <br /> PHONE: 588-5147 8:00 ~ 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I arf~ performing work o~/a property J own or occupy, <br />I am a registered builder OR the autlqorized representative <br /> of 8 registerod builder, <br />The work will be performed by a reSistered buiJder. <br />Other <br /> <br />SIGNATURE OF APPLICANT: <br /> <br />DATE: 10/14/~3 TIME: 11:38:51 <br /> <br />BATE: <br /> <br /> MILL CREEK ESTATES (MN PARK) i RI'~$IDENTIAL, <br /> SITUS ADDR~S$; CONSTRUCTION TYPE: !'SCUtJ~AN~Y: <br /> <br /> ~9PEN ~R SE ~2 b~'~ ~¢~; 8~i OCCUPANT LOAD'. <br /> AUH~VILLE OR 97~25 A~I_LE NU <br /> <br />::~ ~F' BUILDING'. NO OF BEDROOMS <br /> MANUFACTURED STRUCTURE <br /> <br /> MILL CREEK ESTATES MH PARK <br /> ~725 MILL CREEl( RD SE <br /> AUMSVILLE. OR 9732~ SITE NUHBEE: <br /> PHONE: 363-6386 VALUATION: <br /> <br />WlOTH~ ~O~TH'. ~ A~EA'. ' UNITS: ~ I~G. lOT: :OORNER: <br /> ~E ~ ~5' ~75. : SF ~ NO ~ NQ <br /> <br />TYPE: MANUFACTURED STRUCTURE PERMIT OR APPLICATION NO: <br />CONTRACTOR, NO. ~8238 <br />Daniel L Carver <br />11F73 Mill Creek Rd <br />Aumsville. 97325-0008 <br />PRONE: 789-7744 <br /> <br /> ~,. ITEH <br />MAMUEACTURED STRUOTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br /> TOTAL ASSESSED FEES <br /> PREVIOUSRECEIPT$ <br /> THIS RECEIPT: <br /> <br /> :: .BALANOE DUE:: <br /> <br />5~572 <br /> <br />QUANTITY AMOUNT <br /> $~82.00 <br /> $20.80 <br /> $9.10 <br /> <br />$211.18 <br />$226. t8 <br />-$15.88 <br /> <br /> $0.~0 <br /> <br />INVOICE 5~079 <br /> <br /> PAYEE: DeN McCor~&ck <br /> RECEIVED BY: F'B .......... ~_,_ .... ,:~__~._.___~_ ~YPE: IN CHECK ~: 0 <br /> *~ TNIS IS A VALID PERMIT Z~THISPERMIT FEE COVERS ONE INSPECTION AND ONE <br /> REINSPECTION. ALL BLOCKING, STAIRIHSTALLAT~OM,:PIJJMBING~ MECHANICAL. AND ELECTRICAL <br /> CONNECTIONS ARE REOU~RED TD SE COMPLETEDUPON REOUEST FORTH[ F~RST I~SPECT~ON. ~F <br /> ANY 6F THE ET[MS ARE ~NCOHPLETE, AN ADD~TIOHALINSPECTION FEE #ILL <br /> P£RN~T IS VAL~b FOR S~× NONTNS ONLY. RENEiED:FOR6MOMTH$ UPON ~R~TTEN REDUEST FOR <br /> AN £XTENS~OH. PRIOR TD THEEXP~RAT~UH DATEOFTHE :PERMIT. ~F CONSTRUCTION FAILS TO <br /> HEET ALL RE6U~RE~ENTS OFSTATELA#$:AN~HAR~OM COUNTY BUILdiNG AND ZONING ORD~HANCES~ <br />PI,.ANNIId~ ACTIOH: :: <br /> SET~ACKS: FR. i1 <br /> <br /> R8-15 <br /> RR"10 <br /> REMARKS: MFG HUME 8P~ <br /> DIi!~IALD E. WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY - ..... .,~.~_~ ........................ <br /> <br />FORM # MC ~5-56 REV, 4/90 OFFICE COPY <br /> <br /> <br />