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MARION COUNTY BUILDING INSPECTION <br /> <br /> 3150 Lancaster Dr. N.E. · Suite C · Salem, Oregon 97305-1398 <br />Office Hours: 8:00-4:30 * Phone: (503) 588-5147 · 24-HR Inspection Line: (503) 373-4427 <br /> <br /> IMNUFACTUREB DNELLING APPLICATION <br />DATE/TIHE = ~6/1B/97 16:33 ACTIVITY NO 97-~4382 <br />TYPE = ~ Hanufactured Dwelling STATUS APPLIED <br />OCCUPANCY = R-3 APPLIED ~6/1~/1997 <br /> TO EXPIRE 12/~7/1997 <br /> PAgE 1 <br /> <br />WORK DESC : NEW MD REPLACE EXISTING/DIFFERENT LOCATION <br /> <br />SITE ADDRESS : CITY: MARION COUNTY <br /> 11559 MCCLELLAN LN SE AM <br /> <br />CROSS STREET <br /> <br />PARCEL NUMBER : 75440-110 <br /> PARCEL SIZE : .80 AC <br /> <br />OWNER NAME : BAXTER, DONALD <br /> <br />APPL. ICANT <br /> NAME <br /> ADDRESS <br /> <br /> PHONE <br /> <br />COMTRACTOR/ <br /> AGENT <br /> PHONE <br /> <br />INSTALLER <br />PHONE <br /> <br />UNIT SQFT <br /> <br /> 1 <br /> 1 <br /> 1 <br /> <br />: WEST STAYTON R~ SE/NORTH ON MCCLELLAN <br /> <br /> LAND USE: <br /> <br />BAXTER, DONALD <br />11559 HCCELk. AN LN SE <br />AUMSVILLE, OREGON <br /> <br />: 503-769-7238 <br /> <br />97325 <br /> <br />: OCCB: <br />: BAXTER~ DONALD <br /> <br /> MDI LICENSE: <br /> <br />State surcharee <br />State ad~inis~rative fee <br />Zone surcharge <br /> <br />12.25 <br />20.00 <br />20.00 <br /> <br /> Assessed fees 297.25 <br /> Adjust~qents <br /> To~al fees 297.25 <br /> PAYEE: BAXTER~ DONALD Total pex~ents: 297.25 <br /> B~lance due : .80 <br /> <br /> THIS IS NOT A PERNIT. THIS APPLICATION HUST gO THROUGH A SINULTANEOUS REVIEW <br /> PROCESS NHERE ZOHIHG. SEPTIC (IF APPLICABLE) AND SITE PLAN IS CHECKED PR[OR TO <br /> THE ISSU~M'iCE OF A PER#IT. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br /> THAT ALL NECESSARY ~NFORNATION IS PI~VZDED. AS SOON AS ALL REOUIRENENTS OF THE <br /> REVIE# HAVE BEEN HET~ YOU ~ILL BE ~P'I*IFIED TI:IA.~ YOUB,,**P~RNIT HAS BEEH ISSUED. <br /> <br /> *************************************************************************** <br /> <br />-~ ......................................... FOR OFFICE USE ONLY .......... /~,(F ..... ~ ....... <br /> ~ITE / UGB:~ ' / <br /> MAP: 62R ~ONE: AR PROPERTY LOCATOR: 092~13DA02100 <br /> LAND USE CASE NO: <br /> RE~D SETBACKS:Front: ~99 Left: 9~9 Right: 79~ Rea~*: 999 Special: <br /> <br /> PLAN REVIEW : DATE: ZONING REVIEW: DATE: <br /> <br /> <br />