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MARION COUN BUILDING INSPECTION <br />COMMUNI 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 Inspection Line: (503) 373-4427 <br /> <br /> I~ACTURED I)MELL'[NG APPLICATION <br />~TE/T~IIE z e?126196 '16~39 ~TIYZTY NO ~ 96-~5671 <br />l~fPE : ~ I~anufactured ~elli~ STATUE ; ~PI~IEB <br />OCCOF'AI~Y = R-3 ~I~ ~7/26/1~6 <br /> ~ <br /> <br />CORK DFSC = HF~ PL~CFHFHT <br /> <br />SITE hO~RES~ = CITYt fl~RIOH COUNTY <br /> 11637 F~LCDN CT NE ~R <br /> <br />CROSS STREET : EHLEH TO CAROLER LN NE <br /> <br />PARCEL NUH~ER : 7S5§]-371 <br /> PARCEL SIZE : .OAC <br /> <br />OWNER NAHF = GREEN, JOE <br /> <br />APP!.ICANT <br /> NAHF <br /> ADDRESS <br /> <br />PHONF : <br /> <br />COHTRACTOR/ <br /> AG£NT <br /> PHONE <br /> <br />GRFEN, JOF <br />P 0 BOX 759 <br />PORTLANO, DRFGON <br /> <br />503-665-9665 <br /> <br />JOE GREEN INVESTMENT CO <br />GREEN, JOF <br /> <br />INSTALLFR <br />PHONE <br /> <br />97~07 <br /> <br />[IN)T SO FT <br /> <br /> OCCB: 0057652 <br />Mm LICENSE: <br /> <br />Units Description Fee <br />1 Manufactured d#ell~ng fee 245.0e <br />! S~ate surcharge [2.25 <br />1 S~ate administrative fee 20.00 <br />I Zone surcharge 28.00 <br /> <br /> Assessed fees : 297.25 <br /> Adjustments : <br /> Tofal fees : 277.25 <br />PAYEE: GREEN, .JOE To~al pa%nents: 297.25 <br /> Sa)ance ~ue : <br /> <br />11lis IS N~T A PER#IT. Tills ~HI,~T ~ ~ A SlItULTIIEIIIS REVIE# <br />F'lilX/~ll; ~ ZI]NII~, IIEM'IC (IF N:gt. IiII~LE) MI~ 9ITE PLItl IS CHECKEI) PRIOR TI} <br />THE' I~gUA~CE OF ~ PERIilT. IT/I5 THE,41~,~='IX~IBILITY OF THE N:q~'LICA~r TO ~8~URE <br />TI,I~T N,.L I~CEggARY INFORI~Ti~I I~ PJ~I~. ~ glXIN, ~ ALL I~QUIRENENTg OF THE <br /> <br />SIGNATURE OF APPLICANTA ..... _~___~____~__. <br /> <br /> ~ONAI,.~ E WOODLEY, MARION COUNTY BUILDING OFFICIAL / BY CLYHCH <br /> <br />................................... FOR OFFICE USE ONLY ......................... <br /> S~TE / <br /> MAP: ~ ZONE: AR PROPERTY LOOATOR: 031W3~C00~20~ <br /> <br /> REQ~ SETBACKS:Front: 999 Left: 999 Right: 999 Rear: 999 Special: 999 <br /> <br /> PlAN REVIFW : DATE: ZONING REVIEW: ~ATE: <br /> <br /> <br />