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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: 58~-514T 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performln9 work on ~ property I own o¢ occupy. <br />lamaregisferedbuJ?~erOR( Itheauthori:[ed representative <br />of 8 registered build~.r. <br />The wo'rk Wlit be performed by a regisf ere~.l Ouilder. <br />Other. <br /> <br />S~GNATURE OF APPLICANT: <br /> DATE: <br /> <br />ow~E~. I)ATE: 10/11/93 · TTME: 15:14:42 T~J(LOT CATEGORY~. <br /> MILl_ CREEP( ESTATES (HH PARK) RESIDENTIAL <br /> <br /> R ' <br /> ~2~ ASPEN 9R SE ~8 CONTRACT CITY: UG8 , OCCUPANT LOAO' <br /> AUMSVIL[_E O~ 97~25 , AUHrVILLE <br /> <br /> MANUFACTURED STRUCTURE <br /> <br /> ~725 HZLL CREEK E9 SE <br /> ~UMSVII. LE~ 0R_77325 ~TE HUHBER: <br /> rHONE: ~&~-63~ VALUATION: <br /> <br />LO~: ........ BL O0 K'. . S~CTION' ' .......................... ' TOWnSHiP' ' -~A~z ........... ~0~; ........ MAP: <br /> <br /> 55 78 4298, NO NO <br /> <br /> TYPE: HAHUFACTURED STRUCTURE PERH~T OR APPLICATION HO: <br /> CO~TRAgTO~ NO. ~82~B <br /> Daniel L Carver <br /> 11~77 Mill Creek ~d <br /> <br /> PHONE: 76~-7744 <br /> <br /> ITEM QUANTITY AMOUMT <br /> ~iANUFACTURED STRUCTURE PLACEMENT/CONNECTION $182.~0 <br /> ~ANUFACTU~E~ STRUCTURE STATE FEE $2~.~ <br /> MANUFACTURE~ STRUCTURE STATE SURCHARGE '$9.18 <br /> MANUFACTURED STRUCTURE ZONING SURCHARGE $15.eB <br /> <br /> TOTAL 'A~SESSE~ FEES <br /> PREVIOUS RECEIPT8 <br /> THIS RECEIPT $224. <br /> <br /> BALANCE DUE <br /> <br /> PAYEE: Qel McCorMick INVOICE 52~8~ <br /> REC~IVE~ BY: Pti2 ................................... TYPE: IN CHECK ~: <br /> <br /> · THIS IS NOT A PERHIT. THIS APPLICATION HUST GO ~OUGH ~ REVIEW PROCESS WHERE THE <br /> FOLCOWIHG HUST E ~L[T[~. iT IS TE R[~SI~iLITY OF TE APPLICAHT TO <br /> THAT ALL NECESSARY IHFORHATIDN HAS BEEN PROVIDED. <br /> <br />PLANNING ACTION: <br />PLAN R~VIEW: BY <br />ZONINC., BY ~ ..... ~ATE ...... <br />SEPTIC: YZZZ iZZZZiZZZ ........... <br /> CITY JURiSdICTION: BY DATE <br /> RE~ARKS: <br /> <br />SETBACKS: FR 1t <br /> LS-15 <br /> RS-'15 <br /> RR-10 <br /> sP: <br /> <br />FORM ~ MC 15.56 REV, 4/90 <br /> <br />OFFICE COPY <br /> <br /> <br />