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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 Inspection Line: (503) 373-4427 <br /> <br /> MANUFACTURED DWELLING APPLICATION <br />DATE/TIHE : 07/31/96 18:22 ACTIVITY NO : 9&-05794 <br />TYPE : New Manufactured Dwelling STATUS : APPLIED <br />OCCUPANCY = R-3 APPLIED = 07/31/1776 <br /> TO EXPIRE : 81/27/1997 <br /> PAGE 1 <br /> ..................................................................................................................... <br /> <br />WORK DESC : NEW MH PLACEMENT--HARDSHIP <br /> <br />SII'E AQDRESR : CIYY: MARION COUNTY <br /> ~0E73 FRIENDLY ACRES RD SF AM <br /> <br />CROSS SFREET : SHAW HWY <br /> <br />F'AI(CEL I,tUHBER : '75:790-020 <br /> PARCE. L SIZE : 6.0AC <br /> <br />OWNER NANF : M(rRRIS(Ui, AI ICE M <br /> <br />APF'I.ICANT <br /> NAME <br /> ADDRESS <br /> <br />F'HOI,II~ <br /> <br />:: HORR~SON,ALICE M <br />· 1007:~ FRIENDLY ACRES RD <br /> ALIMSVII..LE,, OR <br /> 97~25 <br />: ,~,_ <br /> <br />LAND USE. CU <br /> <br />CON FRAC'FOR/ : OCCB: <br />AGENT : MORRISON~,AL]iCE M <br />PHONE : <br /> <br />)'NSI'A[ LEI;( : MD LICENSE: <br />PHONE : <br /> <br />UH)T SQ FT : <br /> <br />Hni bs Desc l" i.o tio¥l Foe <br />.... ~ ~"~u-~(--~"~-~'d ~welling fee ~,. ~ <br />1 S+:atr~ surcharge !2.25 <br />I State edm~nis~-ative fe(~ 28.~8 <br />1 Zone surcharge 2~.~8 <br /> <br /> Asq~ss~d fees : 297.25 <br /> Ad) us ~mm'~s : .00 <br /> Total fees : ~97, ~,~ <br /> PAYEE: M{)RRISON, ALICE M Total payments~ 297.25 <br /> <br /> ************************************************************************************* <br /> <br /> THIS IS NOT A PER~IT. THIS APPLICATION ~UST ED THROUGH A SIMULTANEOUS REVIEW <br /> PROCESS WHERE ZONING. SEPTIC (IF APPLICABLE) ANB SITE PLAN IS CHECKE~ PRIOR TO <br /> THE ISSUANCE OF ~ PERMIT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br /> THAT ALL NECESSAR~ INFORMATION IS PROVIBE~. AS ~ON AS ALL REQUIREMENTS OF THE <br /> REVIEW HAVE BEEN MET~ Y~ WILL BE NOTIFIE~ THAT YOUR PERMIT HAS BEEN ISSUE~. <br /> <br /> SIGNATURE OF APPLICANT: <br /> <br /> *******************************************************************--********** <br /> DONAtl) E WO,')O!.EY~ MARION COUNTY BUILDING OFFICIAL, / BY DFREILI~'~ <br /> <br />...................................................................... FOR OFFICE [ISF ONL. Y .................................. <br /> SITE / UGB: <br /> biAF'~ 4H <br /> <br /> RFQ1) SE'F~AI~:KS~ Frrmt': Le':'b~ R:j ght: Rear: Spec J.a I: <br /> F'i.Ai,I Ri V]I.W : DA[[~: 7[lhJ]N& REVIEW:: DA)E: <br /> <br /> <br />