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SECTION 6 .,..101,1t OWNER:ACKNOWLE .GEMENT.(Onenameperpox) `:...:;: :,-::;' <br /> El Person 0 Business ❑Trust in Guardian <br /> Le u , Gretchen, W Phone:707-266-4017 <br /> ` al Name:Hughey,Legal 9 Y <br /> (last,first,middle) <br /> W MaiIing Address:1381 W View Ct NE <br /> :' " City:Salem state:OR GIP:97317 <br /> Email:gretchen.hughey@gmail.com <br /> W Right of <br /> g E]Yes ❑No <br /> ':Zs Z . Survivorship: <br /> Signature: Date: <br /> 0 Person ❑Business ❑Trust ❑Guardian,: Legal Name:Hu he , Brian, B Phone:503-383-8935 <br /> ..] _ (last,first,middle) g y <br /> la` Mailing Address:1381 W View Ct NE <br /> .,, .! city:Salem State:OR GIP:97317 <br /> Email:bryanhughey@gmail.com <br /> Right of E Yes ❑No <br /> '.'2...� Survivorship: <br /> Y' Signature: Date: <br /> ❑Person ❑Business ❑Trust ❑Guardian <br /> J- ll,:r Legal Name: <br /> M; Phone: <br /> e':+ (last,first,middle) <br /> '': • Mailing Address: <br /> City: State: ZIP: <br /> Email: <br /> W: Right of ❑Yes ,❑No <br /> ',XI.: Survivorship: <br /> Signature: � Date: <br /> - _ ❑Person ❑Business ❑Trust ❑Guardian <br /> .d.', Legal Name: <br /> (last first,middle Phone: <br /> (l ,f t <br /> I" . Mailing Address: <br /> ��- City: State: GIP: <br /> 0 <br /> Email: <br /> W Right of <br /> Z,': Survivorship: El Yes ❑No <br /> Signature: Date: <br /> NEW OWNER ACKNOWLEDGEMENT OF SALE/CHANGE OF OWNERSHIP <br /> I affirm that the information provided herein accurately reflects the ownership of the structure at the completion of the sale or change <br /> of ownership.I understand that the home cannot be relocated without first completing this application and purchasing a trip permit <br /> from the Building Codes Division or through one of its county agents. <br /> I understand that the seller/owner is responsible for submitting this application within 30 days after the close of the sale,and that all <br /> buyers and sellers will be notified by mail when the application is approved.If the application has not been submitted after 30 days,I <br /> may complete the filing under ORS 446.64(1). <br /> I understand that each lessor,mortgagee,trust-deed beneficiary,lien holder of record,and security interest holder must be listed on <br /> this notice.If none are listed,the structure must be free and clear of all mortgages,deeds of trust,security interests,and liens. <br /> Page 3 <br />