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FOR OFFICE USE ONLY <br />Received by: . <br />Zoning Validation <br />Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem; OR 97301 <br />8:00 am.4:30pm Phone $88-5147 <br />Code.A.Phone 588r7904 <br /> FAX $$8-7945 <br /> <br /> MANUFACTURED STRUCTURE PLACEMENT <br />COMPLETE ALL SECTIONS, ! TI:IKOUGH 4 PERMIT APPLICATION <br />1. Job Description <br /> <br />FOR OFFICE USE ONLY <br /> <br />2. Location of Installation ,:: <br /> <br /> 3, Contractor Information <br /> <br /> ( ) I un~nd ~at I must ~s~t as a!~t~u~ con~ ~ ~ s~u~ ~.s~ ~ ~ for s~e before or u~n c~plefion. <br /> <br /> ~ I ~ ~u~ntracmrs, I <br /> ~ I &~gc my m~d ~ do Mm a g~ ~c~, I ~ ~n~' Wi~ a C~e~r who i~'m~sm~d ~ ~e Cond~c6on Cofltract~s BOa ~ and wi~ <br /> <br /> Au&o~d agent or leasee: <br /> <br /> 4:: Fee Schedule <br /> A, (1)~n~u~dH~e ,::, :; '' ' · ,. <br /> <br /> (~) Sa~gumha~ , ' , "9.10~ -',, ,,: :' ,, <br /> (4) ~ng Su~a~e (15,~ <br /> <br /> h',l'd <br /> <br /> / <br />I hereby certify ~at the above i~o~afion i~ ~mfit ~d ~at I hue mad'~d unden~nd ~e ~fomati~ Nofic6 t0 ~cny Owfiers aboa[ C~strucfion Resp~sib~fies <br /> <br /> MC 15-64 <br /> <br /> <br />