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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO. 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE 588-5147 <br />CO~E-A-P~ONE 4:30 P.M. - 8:00 A.M. <br /> <br />) <br />DATE= 09/28/88 TIME: <br /> <br /> 10955 MIX RD <br />AU~SVZL. LE OR <br /> <br />I am performing work on a property I own or occupy. <br />lamaregistered buildorOR( )thea~Jthorlzedrepresentative <br />of ,~ registered builder, <br />The work will Do performed by a registered builder. <br />Other_.__ <br /> <br />11=57;24a <br /> <br />9?325 <br /> <br />use OF eU~LSiN~; <br /> <br />MAILING ADDRESS: <br /> <br /> SAME <br /> <br /> PHONE: 749-1354 <br /> <br />LOT: ',BLOCK: <br /> <br />[ ~6O~ION: 05 fOWNSH~P: <br />[AREA: 20. 0000 BNrTS: <br /> <br /> TAX LOT: : CATEOORY: RES I DENTIAL <br /> <br />SE ~ <br /> MA. RION .COUNTY i NO <br /> <br /> 3 <br /> <br /> SITE NUMBER: 5515 <br /> VALUATION: <br /> <br /> 9S 1N EFU 50 , <br /> AC ~RREO. LOT: NO :CORI~f.~: ! <br /> <br />TYPE: MOBILE HOME <br /> <br />CONTRACTOR, NO- <br />,iX, FRANCIS A. <br />~AME: <br /> <br />PHONE:: 749~'1354 <br /> <br />PERMIT OR APPLICATION NO: 11189 <br /> <br /> ITE~ <br />MOBILE HOME FIRST WIDTH <br />MOt3ZL.E HD~IE AODTL. WIDTH <br />IvE)8ILE HOME ZONING SURCHAR~3E <br />FLEET SURCHARGE -ZONE 3 <br />MOBILE HOME STATE ~RCHARGE <br /> <br />TOTAL ASSESSED ~EES <br />PREVIOUS RECEIPTS <br />THIS RECEIPT' <br /> <br />BALANCE OUE <br /> <br />QUANTITY AMOUNT <br />1 $35.00 <br />I <br /> $2.50 <br /> $3.84 <br /> $2.5o <br /> <br />$58.84 <br /> 58.84 <br /> $o.oo <br /> <br /> $o.oo <br /> <br /> RECEIPT <br />RECEIVED BY: PS CHECK <br /> <br />~NST~CTI~ O~ FOR A PERIOD 0F 180 OA~;OR IF ~ST~OTI~ FAI~ TO ~E~ ALL <br />REdIReCTS OF STATE ~ ~D ~RI~ ~N~ BUILDING::~B <br />~ALL BEdE NULL ~D ~ID. ' <br /> <br />REMARKS: MOBILE HO~E PLACEMENT FOR HARSH <br />PLANNING ACTION: CU <br /> <br />DONALD E. NOODLe, MARION COUNTY BUILDING OFFZC[AL / BY ..................... <br /> <br /> <br />