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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM1 OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:80 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br />OWNER: ; TAX LOT: ..... <br /> SANTIAM HOMES RESIDENTIAL <br /> <br /> 112 CARMEL ~R ?5:6V~AcTCf~ 'U~e: Oc~OPANfLOAD: <br /> AUMSVILLE OR ?7325 ' AUMSVILLE : NO , <br /> <br /> MAHOFACTURED STRUCTURE <br /> MAIEIN~ ADDRESS; <br /> : HILL CREEK ESTATES <br /> AGENT: CRAI6 LUCAS ,' <br /> i SITE NUNBER: 73-8~481 <br />, PHONE: 769-7744 YALUATION: <br /> <br />:WI~¥H; ,DE~N: AREA: I UNITS: IRREG. LOT: i CORNER: <br />~ 55 I 84 4&20. ! SF NO NO <br /> <br /> 'rYPE= HANUFACTURED STRUCTURE PERHIT OR APPLICATION HO: 58587 <br /> CONTRACTOR~ HO. <br /> Da~ie~ L Carver <br /> :1. t373 Miii Creek Rd <br /> Au~sville. 77325~0000 <br /> PHONE: 76~-7744 <br /> <br /> ITEM QUANTITY AMOUNT <br /> MANUFACTURED STRUCTURE PLACEMENT/CONNECTION $182.00 <br /> ~ANUFACTURED STRUCTURE STATE FEE $28.00 <br /> MANUFACTURED STRUCTURE STATE SURCHARGE $?.,10 <br /> <br /> TOTAL ASSESSE~ FEES $211.10 <br /> PREVIOUS RECEIPTS $211.:L0 <br /> THIS RECEIPT $8.00 <br /> <br /> BALANCE DUE $8.00 <br /> PAYEE: INVOICE <br /> RECEIVED BY: PB ............ ~__iz~i~ ............ TYPE: CHECK ~: 0 <br /> <br /> *~ THIS IS A YALI~ PER~IT ~Z THIS PEI~HIT FEE COYERS ONE INSPECTION AN~ ONE <br /> EEINSPECTION. ALL SLOCKIN~,ST~IRINSTAI.LATION; PI.OHBIN6, NECHANICAL. AN~ ELECTRICAL <br /> ~SNNECTiONS ARE RE~UIRE~TOBE CONPLIEI'EDUPON REOUF~TFOR THE FIRST INSPECTION. IF <br /> ANY OF THE iTENS ARE INCOHPLETE. AN ABBITIONAL INSPECTION FEE BILL BE <br /> PERNIT IS VALID FOR SiX NON~HS ONLY, RENEl~E~ FOR ~HONTHS UPON ~RITTEN REQUEST FOR <br /> AN EXTENSION. PRIOR TO THE£XPIRATIONDATE OFTHE~ERNIT.: IF CONSTRUCTION FAILS TO <br /> NEET ALL RE~OIRENENT$ DF STATE IJ~WS AN~ NARION COUl~r¥ BUILDIN~ AN~ ZONiN60RDINANCES~ <br /> PLANNING ACTION: <br /> SETBACKS: FR 11 <br /> LS-15 <br /> RS-15 <br /> RR-10 <br /> REMARKS: HFG HOME SF'~___ <br /> DOMALD E. WOODLEY. MARION COUNTY BUILDING QFFIClAL/ BY .............. _~_ <br /> <br /> OFFICE COPY <br />FORM # MC 15 56 REV. 4/90 .. <br /> <br /> <br />