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FOR CITY YAL}iDATION' <br />IRecavo. By: <br />Zoning Validation: .... ~/~ <br />IDate: ?~,~-/~ "~'t'>5-~ <br /> <br />COMPLETE ALL SECTIONS. I THRC, UGH 4 <br /> <br /> 1. JOB DESCRIPTION <br /> ( ~'~ew Placement <br /> ( ) Reptaeemctlt <br /> ( ) A~ditional Unit Add-on <br /> <br /> ( ~oed <br /> ) Metal <br /> ) VinTI <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMIJNITy DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> <br /> 8:00am.4:30pm Phone <br /> 24 HR lr~speetlon Line <br /> FAX 588-7945 <br /> <br /> MANUFACTURED DWELLING <br /> PERMIT APPLICATION <br /> <br />CIT_ X USE ON_IX <br /> <br /> ( t--~mp <br /> ( ) Steel <br />i ( ) Metal <br /> <br />( )Detached <br /> <br />'Sections 2_ .2.. <br /> <br />Square Footage: /~-t~ No, of Bedrooms: <br />PitS*t: ~P Energy: yt~ <br /> <br />2. I,OCATION OF INSTALLATION q,,g--B/ <br />I,gbAd0wsa: V/ V ~.~7~-~O/~) ~-.l~'. I'ri'xA~¢°unt'#:.,~'~,q?/' ICr°ssSt'~am:/~I~ (~- <br /> <br />Map; <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />i am an AUTI- ORIZED REPRESENTATIVE of th* property owner or the c0nlraetor. <br /> <br />4. FEE SCHEDULE <br /> <br />$60.00 <br /> <br />or if work is suspended for 180 days. <br />NA ME OF APPLICANT (Ple~';c It/it'd): ~.~ <br /> <br /> <br />