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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG NO 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />PHONE:: 588-5147 8::00 - 4;30 <br />24 HOUR CODE-A-PHONE, 588-7904 ,/~ ~.. --~ .'- <br /> <br /> D~,¥E.: t2/l?/g0 'riME: 11.~ 13..41 <br />OWNER <br /> <br /> PEIE~, GARRETT <br />SITI IS AD[3 RDSS <br /> <br />RESI DbN[ IAL <br /> <br /> 7913 MILL GREEK ROAD <br />AUI'4SVILLE OR <br /> <br />97325 <br /> <br />SE <br /> <br />l~¢,RiC~f4 COLIN rY NO <br /> <br /> STONE FIELD GLEN <br />?40 BOONES ROAD SE <br />SALB~I 9?306 <br /> <br /> VALUAT I ON: <br /> <br /> 1 26 8S 2~1 AR C,"' 81 ~" <br /> 5. ~ NO NO <br /> <br />[YPE: M(~ILE HONE <br /> <br />CONIRACfOR, NO, <br /> <br />740 BOON~ ROAD SE <br />SALEt~ 97308 <br />FIHONE: 378-7556 <br /> <br />PEP,~IT OR APPLICATION NO: 9029355 <br /> <br />MOBILE HOME BA~E FEE <br />MOBILE HONE STATE FEE <br />MOBILE HOME ZONING ECJRCHARGE <br />FLEEf SURCHARGE -ZONE ~ <br />M(]f3ILE HONE ~TAIE SURCHARGE <br /> <br />TOTAL AIBS~ED FEES <br />PRE¥iOU$ RECEIPT~ <br />THIS RECEIPT <br /> <br />I~UANIllY <br /> <br />AMOUNI <br /> ~8g.25 <br /> 15.75 <br /> 5.25 <br /> 5.25 <br /> <br />$119.34 <br /> $o.oo <br /> <br /> ~A~C~CE OUE $0.00 <br /> PA.Y, EE: P~,fEf~=~lN, C4ARREI"'F' ~q ~ RECEIPT 31019 <br /> <br />* 1HiS IS NOT A P~IT. THIS APPLi~TI~ ~ ~ ~ A R~I~--~ ~R~ ~ <br />FOL~IN8 ~ST BE ~PL~T~O. IT I~ TM~ ~SIBILiTY OF THE APPLI~T TO ~RE THAT <br />ALL N~ iNFO~Ti~ H~ BE~ P~IDED. <br /> <br />RR 2o SP <br /> <br /> OFFICE COPY <br />FORM # MO 15-56 REV 4/90 <br /> <br /> <br />