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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 * Phone: (503) 588-5147 · 24-HR Inepectlon Line: (503) 373-4427 <br /> <br /> MANUFACTURED DWELLING APPLICATION <br />DATE/TIME : 86/10/76 16:3S ACTIVITY NO : 96-84158 <br /> TYPE : Mew Manufactured Dwelling STATUS : APPLIED <br /> OCCUPANCY : R-3 APPLIED : ~6/1B/19~6 <br /> TO EXPIRE <br /> PAGE 1 <br /> <br />WORK DESC : I,tL'W MH REPLACFHENT <br /> <br /> SITE ADORF:SS : Ct(~: M~,~_[O,,) COUNTY <br /> ~ BU'FTEV)iLLF Ri) F)E AN <br /> <br />CROSS SfREET : ,;T F'AUL HWY RE <br /> <br />F'ARCEL NLIMBFR : 7'579~-000 <br /> F ARt.E.I. S ,r. ~E : .OAC <br /> <br />tlWNER NAM[:' : fit:'(iY,FORREST <br /> <br />APPLECANT <br /> NAME <br /> <br /> FORREST <br />:t 94:~6 BUTTEV ti RI) <br />· ~ I'~.,RA OR <br /> <br />tIN:IT SQ Fl : <br /> <br /> A, !~e!~!;(.'l(! fees 297.25 <br /> Ad justr,~ents . I;}0 <br /> Tota~ f~es 297.. 25 <br /> PAYF:F:: HEGY~FORRFS'F Total f~ay~,lents: ,97,,.,~ <br /> ~ TI ~ I'IC e due <br /> <br /> T~IS IS NOT A PERMIT. THIS APPLICATION MUST 6O THROUGH A SIMULTANEOUS REVIEW <br /> P~0CESS WHERE ZONINg. SEPTIC (IF APPLICABLE) AN~ SITE PLAN IS 6HECKE~ PRIOR TO <br /> THE ~8UANCE OF A PER~IT. IT ~B THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br /> THAT ALL NECESSARY INFORMATION IS PROVIQEB. AS SOON AS ALL REQUIREMENTS QF THE <br /> ~[V~EW HAVE BEEN ~ET, YOU WILL BE NOTIFIED THAT YOUR PERMIT HAS BEEN ISSUE~. <br /> <br /> SIG~A'fHF~E OF APPLTCANT: <br /> <br /> ********************************************************************************** <br /> DOHAIO ~:' WF)OOLEY~ HARIUN 00~JNTY BUll f)XNF; OFFIC'[A!.. / BY DFREILi[N <br /> <br />..................................... -.-F[:H:~, OF:!:;iCF USE ONLY ....................................................... <br /> '7;/I,iE: EFU" r'RflPERTY L[!CATOR': <br /> <br /> <br />