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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97'301 <br /> <br /> PHONE: 588-5147 8;00 - 4::30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> of a rugistered bu{Ider, <br /> The work will be performed by a registered builder. <br /> Other <br /> <br /> ]DATE; :1,0/07/9:3 TIME.' 8: .!.7:06 <br /> .......... <br />i OWN~R; SANTIAM HOMES <br /> <br /> SITUS ADD'SSS; .... i d~COPAN~Y: <br /> <br /> 218 BELLEVUE DR -- 70 <br /> AUMSVILLE OR 97~25 ;c~jl~t~l~'~ilr,~ Or~) :OCCUPANT LOAD: <br /> <br />: MAILING ADDRESS: : SUBDIVISION: <br /> ~ ~ILL 6~EEK ESTATES <br /> AGENT: CRAIG LUCAS <br /> ......... SiTE MUHBER~ <br /> PHONE: 76~-7744 VALUATION: <br /> <br />TYPE= HANUFACTURED STRUCTURE <br />CONTRACTOR~ N~. ~82~8 <br />Daniel I_ Carver <br />11~7~ Mill Creek Rd <br />AuMeville~ OR 97~25-~00~ <br />PHONE: ?69-??44 <br /> <br />PERMIT OR APPLICATION NO: <br /> <br />ITE~ <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTUREB STRUCTURE STATE FEE <br />HANUFACTURED STRUCTURE STATE SURCHARGE <br /> <br />TOTAL ASSESSEBFEES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> $~.10 <br /> <br />$211.10 <br /> $0.88 <br />$211.1o <br /> <br /> ~ BALANCE DUE $0.00 <br />PAYEE:' Del .McC%Mick' ~ INVOICE 52884 <br /> <br />* THIS IS NOT A PERt~IT. THIS APPLICATION :HOST GO ~ROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING HUST ~E COHPLETE~. IS THE RESPONSIBILITY OF THE APPLICANT TO A~SURE <br />THAT ALL NECESSARY /NFORHAT[O~ H~ BEEN PROV~DE~. <br /> <br />PLANNING ACTION: <br /> PLAN REVIEW: BY ~ DATE~O- <br /> ZONING: BY ............ DATE <br /> SEPTIC: BYii:'::i::iiiiiii BATEiiiiiiiiiiiii <br /> gl'fY JURISDICTION: BY ............. DATE_ <br /> RE~ARKS: MFG HOME <br /> <br />SETBACKS: <br /> <br />FR ll <br />LS-Z5 <br />RS-15 <br />RR'i8 <br />$1d: ...... <br /> <br /> IFFICE COPY <br />4 # MD 15,56 REV. 4/90 <br /> <br /> <br />