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FOR~ OFFICE USE ONLY <br />Zoning ValJdaUon~f <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br />220 High Street NE I. FOR OFFICE USE ONLY] <br /> Salem, OR 97301 |~!~y Setback Requirements: / <br /> g:00am-4:30pmPhoneSgg-5147 FrOnt: ~i~]~r'll Rear: ~ /d"] <br /> <br /> MANUFACT,,U, RED STRUCTURE PLACEMENT <br /> 1 I HROUO~I 4 PERNflT APPLICATION .... ~""~' <br />cOMPLETEALLSECTION$." ~)O ~ /~JU~ [ I~ <br />L Job Description <br /> <br />2, Location of Installation <br /> <br /> ~tl~o,:tt~ ', ~- ~73xS. . ..... Site No, , ................... <br />Sob~visJ~ Lot I Bl~k Urban Growth Bounda~? <br /> <br />Sec6~l ~bwns~p Range ~ Map Water Su~ly: <br /> ............... Privam Well ( ) Spring <br />~Widm ~( '""~;tD~ ~, Ae~s I~g,~t Comet Comms~yWO5~ City <br /> <br />3. Contractor Information <br /> <br />( <br />( ) I u~ders~d ~at I must ~r as a constmc6~ ~t~c~ ff &e sl~u~ is sold or offend for sale before or u~n completion. <br /> <br />( ) I wi~ b* my ow~ gmeral contractor. <br /> <br />If I him sobcontgaetots, I will hire only subcontractors registered with the Constmction Contractor~ Board, <br />If I change my mind and do him a general contractor, I'~ill contract with a emmmtor who i~ mgis[ered with the Consta~oction Comtaetot's Boo ad. and will <br />;,nm~iately notify Marion County of the name of the contractor. <br /> <br />(~) I am a r~gis~d builder O~R the authorized mpresentative of a registered builder. <br /> <br />4. lee Schedule <br />A. (1) Manufactured Home <br />or Modular Unit PlacementlCmnection @ $182.00-- <br /> <br /> (2) S~at~ Fee ~ 20,06= <br /> @ 9,10--~ <br /> C3/ State $ureha~e @ 15.00 = <br /> (4) Zoning Surcharge (15,¢0 if appllcable) ~ <br /> · TOTAL: <br /> <br />B. (Il Mfg,'d Structure Storage Fee <br /> @ $ ~5.00--__ <br />(2) Mfg.'d $tmcmr~ Slorage R~newal @ 25.00 =__ <br />(3) Zoning Sotcl~arge (15.00 if applicable) @ 15.00 -- <br /> <br />C. Additional Inspection <br /> oiReimpecti0n <br /> <br />D. I~vesilgation Fee <br /> <br />E. Othex i~sI~¢tions nol Ii s~ed <br /> @ 40,00 per hour (2 hoar minfinmn) <br /> <br />@ $60.00= , , , <br /> <br />@ $40,00 <br /> <br />TOTAL= <br /> <br /> <br />