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MARION COUNTY BUILDING INSPECTION <br />COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street;NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 * Phohe: (503) 588-5147 * 24-HR Inspection Line: (503) 588-7904 <br /> <br /> HANUFACTURED DWELLING APPLICRTIOH <br />OATE/TIHE = 01/12/9& 11=3& ACTIVITY HO : 95-12~62 <br /> <br /> - APPLIED <br /> TO EXPIRE = i1/84/[795 <br /> PACE 1 <br /> <br />WORK D~SC = REINSPECTION PEE/PROViDE~ NOiACCESS <br /> <br />S [fE ~DDRF.,~;S = <br /> 225 Bli:'I,,,I,,EVUE DR ~H <br /> <br />C R O,r.'~ S STREET <br /> <br />PARCEL NUNflER .,, 56281-000 <br /> PA RI';I'_-: L. S;[ZE <br /> <br />OWNER NAHE : L, IEZSURELAN~ HOHES <br /> <br />AP~ I.,[I,ANT NAHE <br /> <br />PHONE .-. <br /> <br />CONTRACTOR/ <br /> .' <br /> PHONE : <br /> <br />:1' NSTA),,[, El;: <br /> PHONE : <br /> <br />UNI'T' SQ F'T <br /> <br /> 1 Re:i, nspectio~ fee <br /> :I. State' ad~xinistr'at'ive fee <br /> <br />HD LICF-NSFr, <br /> <br /> ................................................................. 2';~ f";;;"~'O' <br /> <br />~d ju.mtMents : ~00 <br /> <br /> · Total )ay~ents: .80 <br /> PCY~[~: , , . ~elance due : ;~25,, 00 <br /> <br /> THIS IS NOT A PERNIT. THIS APPLICATiOH HOST ~0 ~ROUGH A SIHULT~NEOUS REVIEW <br /> PROCESS ~HERE ZONINg~ ~EPTIC (IF APPLICABLE) ~HO SITE PLaN IS CHECEED <br /> THE ~SSUANCE'~F A PEEHIT. IT IS THE RESPOHSI~ILITY OF THE APPLICANT TO <br /> THAT ALL NECESS~Y IHFORHATIOH IS PRDVIDED. AS ~OH ~S ~LL EEGUIREHEHTS OF THE <br /> REVIEU HAVE BEEN HET~ Y~U ~ILL ~E NOTIFIED THAT YOUR PERflIT HAS BEEN <br /> <br /> f)~'~Fhd P E W()ODf,,EY,~ HAR:[OI,I COUNTY BUI[.DII~G!OFFICIAL / BY CRICE <br />............................................................................................... FOR OFFICE USE ONLY ............................................................................... <br /> Z('IWE:~ RH PROPERTY;ILOcA'rOR: ~SiW3eC <br /> <br /> · ¢ , x, ~ ? ?9 L'..'.! f"'['.': 999R I.-,~ 999' ReaY: 999 < <br /> <br />Il'!, AN :k VTI::'k t; I/A'T'~'Z;' Z{IN] N(.; F~[-.:V].I:iW:; i)(]'ll:'.:: <br /> <br /> <br />