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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: S88-7904 <br /> <br />Other____ <br />this document, <br />DATE: 10/~7/~ TIME: 1~:,~7:i7 <br />:OWNER: ALLEN, MICHAEL TAX LOT: ,c~k~j;~J~ENTIAL <br /> <br />: 23~ ~ELLEVUE 9R -- 8~ <br /> AUMSVILLE OR 77~25 ~[E ~dtCUPANT LOAO: <br /> <br />us~ OF BUlLD~NUFACTURED STRUCTURE <br /> <br />MAILING ADORESS~ ........... SOeCIO,~i~iM.[~L CREEK ESTATES <br /> AGENT: CRAIG LUCAS/SAMTIAM HOMES <br /> 769-7744 <br /> PHONE: VALUATION: <br /> <br />TYPE: HAHUFACTURED STRUCTURE <br />CONTRACTOR, NO~ 38238 <br />Daniel L Carver <br />1137~ Mill Creek Rd <br />Au~eville, 97~2§-0800 <br />PHONE: 7~9-7744 <br /> <br />PERHIT DR APPLICATION HO: 905852§ <br /> <br /> ITEM <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $182.00 <br /> $28.00 <br /> $9.18 <br /> <br /> TOTAL ASSESSED FEES $211.10 <br /> PREVIOUSRECEIPTS $0.00 <br /> THIS RECEIF'T $211.10 <br /> ~ / BALANCE OUR $0,,00 <br />PAYEE: Del ~cCormick ~'~ INVOICE 52919 <br /> <br />* THIS IS HOT A PERMIT. THIS APPLICATIONNUST. GOTHROUGH AREVIEO PROCESS WHERE THE <br />FOLLONIN~ HUST BE COHPLETE1), ITIS THE RESPONSIBILITY OF THE APPLICANT TO AS~URE <br />THAT ALL NECESSARY iNFORHATION HAS BEENPROVI~E~. <br /> <br />PLANNING ACTION: <br /> PLAN REVIEW: BY ~ DATE \O- <br /> ZOHIfl6: BY ........... DATE ..... ~- <br /> <br /> CITY JURISQICTIOId: BY ............. ~ATE .............. <br /> REMARKS: MFG HOME <br /> <br />SETBACKS. <br /> <br />FIB 11 <br />L8-15 <br />RS-15 <br />RR-10 <br />SP~___ <br /> <br />OFFICE COPY <br /> <br /> <br />