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MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 o Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 * Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br /> HAHUFACTURED DWELLING APPLICATION <br />DATE/TIME : 06/14/96 12:22 ACTIVITY NO : 96-e4313 <br />TYPE : New Manufactured Dwelling STATUS : APPLIED <br />OCCUPAHCY = R-3 APPLIED : ~6/14/1996 <br /> TO EXPIRE : 12/11/1796 <br /> PAGE 1 <br /> <br />WORK DESC : REPL: MF~ UH]T <br /> <br />SITE Al)DRESS : CITY: MARION COUNTY <br /> 77&3 SHAW HY SE AM <br /> <br />CROSS STREKT : D.I.MAR <br /> <br />PARCEL NUMBER : 57788-000 <br /> <br />PARCEL SIZE <br />OWNER NAN~ <br /> <br />APPLTCANT <br /> NAME <br /> AODRESS <br /> <br />PHONE <br /> <br />3,,2AC <br /> <br />: RAltr. IFI:~ M]CHELE <br /> <br />: 7263 SHhW HWY SE <br />AUMSVILLE, ORE~ON <br /> 97325 <br />: 503-749-1245 <br /> <br />CONTRACTOR/ : OCCB: <br />A(;ENT : RA'[LIFF, MI*CHELE <br />PHi!NE : <br /> <br />INSTALLER : MI) LICENSE: <br />PHONE : <br /> <br />HN1T SQ FI : <br /> <br />Units Oescr i,p.t im~ F'l~e <br />'f M~,~i~r*ed dw~Tl-~i~g fee <br />~ State surcharge 12 ..... <br />1 State adm~'dsT-~ative fee <br />~ Zone surcharge 2~. <br /> <br /> Assessed fees : 297.25 <br /> Adjustments : .00 <br /> Total fees : ~YT.~ <br /> PAYEE: RAT[.~FF~ HILHE :E Total paxments: ~..~7. ~,,.~'~' <br /> Balance due : .~8 <br /> <br /> THIS IS HOT A PERHIT. THIS APPLICATION ~ST GO THROUGH h SIHULTANEOUS REVIEW <br /> PROCESS ~HERE ZONING. SEPTIC (IF APPLICABLE) AND SITE PLAN IS CHECKED PRIOR TO <br /> THE ISSUANCE OF A PERHIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br /> THAT ALL NECESSARY IN~ORHATION IS PROVIDED. AS SOON AS ALL REQUIREHEHTS OF THE <br /> REVIE~ HAVE BEEN HET, YOU ~ILL BE HOTIFIE~ THAT YOUR PERMIT HAS BEEN ISSUE~. <br /> S~GNA'F[IRE OF AF'PL:[CAN[: ~~ <br /> <br /> Df)HALO E WODI)i.KY: MARION (](]liNTY I:(tJlJ:):l~(: OFF:C:AI. / BY (;LYNCH <br /> <br />.................................................................. FOR OF~:CE USE {iNLY .................................................... <br /> S:(!'l:: / H¢~:;: <br /> <br /> R~'~D SETBACKS:Frnn~:~ 999 ~:~,f'b~ 999 F~:.:jhk= 999 ~:::~.~ar~', 999 S'pec:[~].: 999 <br /> <br /> Pi. AN i:,:~ V~:;~ ~ b,¥1'l:~ ZON:[I,I~; R[:,VZ~:~I2 DAf'! f~ <br /> <br /> <br />