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MARION COUNTY BUILDING INSPECTION <br />SENATOR SLOG, NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 9"7301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: S88-7904 <br /> <br /> Iarn performing work on a property I owr~ Ct' occupy. <br /> I 8rna rogistered builder OR( ) the authorized representative <br /> ct a registered builder, <br /> <br /> Other ..... <br /> <br />OWNER; SANTIAH HOMES <br /> <br />SITUS AOORESS: <br /> <br />SIGNATURE OF APPLICANT: <br /> <br /> 112 CARMEL DR. -- ~/~ .................... ~08ouPANTLbAD <br /> AUMSVILLE OR 97;~2§ , ~EE~ u~ <br />us~ oF mU~LO~NUPAcTuRED STRUCTURE <br /> <br /> MILL CREEK ESTATES <br /> AGENT: CRAIG LUCAS <br /> <br /> PHONE: 7&~-7744 VALUATION: <br /> <br />WIDTH: <br /> <br />e~.0CK; ...................... $~¢..TION; TOWNSHIP: : RAN~: ' '~f~-'. N~P: <br /> <br />TYPE: flANUFACTURED STRUCTURE PERH~T OR APPLICATION NO: <br />CONTRACTOR~ NO. 38238 <br />Daniel L Carver <br />11~7~ Mill Creek Rd <br />Aumsville, 07325-0000 <br />PHONE: 789-7744 <br /> <br /> ITEM <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTt)RED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br /> <br /> TOTAL ASSESSED FEES <br /> PREVIOUS RECEIPTS <br /> THIS RECEIPT <br /> <br />PAYEE. Del McCormick <br />RECEIVED BY: ~M2 ........ -J,~¢~= ....= ......... ~ ..... ~ TYPE: IN <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> <br /> $9.18 <br /> <br />$211.10 <br /> $0.00 <br />$211.10 <br /> <br />$0,00 <br /> <br />INVOICE 52?02 <br />CHECK ~: 0 <br /> <br /> THIS IS NOT A PERHIT. THIS APPLICATISH HUST OD THROUGH A REVIE~ PROCESS ~HERE THE <br />FULLO~IHG HUST BE COHPL~T£D, iIT:IS'THE RESPOHSI~IL~TY OF THE APPLICRHT TO ASSUR£ <br />THaT ALL HECESSARY IHF~RHATIBH HASBEEHPRO~IBE~. <br /> <br />PLANNING ACTION: ~¢- <br />PLAN REVIEW: BY ~ ~ DATE <br />ZONING: BY ......... DATE .......... <br /> <br /> CITY JURISDICTION: BY ......... <br /> RI;MARKS. MFS NOME <br /> <br />SETBACKS: FR 11 <br /> LS"15 <br /> RR-le <br /> SF'Z___ <br /> <br />*o.~ *,~c ~.~ *e,,, 4/e0 OFFICE COPY <br /> <br /> <br />