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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLOC. 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 /> lamaregiGter~dbuilderOR( ) the authorized representative <br /> of a registered builder. <br /> The work will be performed by a registered builder. <br /> Other <br /> <br /> DATE: 04/0?/92 'TIME: 15'.34.:03 <br /> WEBER, JOg <br />(SITUS ADDR~BG~ <br /> <br />SIGNATURE OF APPLICANT; <br /> <br /> DATE: <br /> <br /> fAX LOT; CATEGORY: <br /> CONSTRUCTION TYPE OCCUPANC~ <br /> Ur3B'. OCCUPANT LOAD. <br /> <br /> 250 YE]~ CT CONTRACT CITY <br /> AUF~SV I LLE OR 9?325 <br /> AUIV~ViLLE <br /> <br />UBE OF BUILDING; <br /> <br /> IVLANU FACTURED.. S'[ RUCTU RE. <br />MAILING ADDREss SL ~DIVISION' <br /> <br />EVERGREEN ES'fA'f'~ <br /> <br /> PHONE: SITE NUI~SER: 92-01394 <br /> VALUATION: <br /> <br />LOT' BLOCK: SECTION; TOWNSHIP: RANGE ZONE <br /> 29 25 8S 2w RM <br /> WIDTH DEPTH. AREA UNITS RREG LOT: CORNER <br /> 55 85' SP YE~ NO <br /> <br />L4Ap. <br /> <br />'TYRE: MANUFACTURED STRUCTURE PERI',I['f' OR APPLICATION NO: 9039220 <br /> <br />CONTRACTOR, NO. 38238 <br />Oan~e'l L Oa~ver <br />11373 Mff"l-I Creek Rd <br />AuP~vfl'l"le, 97325-0000 <br />PHONE: ?69-??44 <br /> <br />I TEl4 <br />MANUFAC'f'URED STRUCTURE PLACEIViENT/CONNECTfON <br />MANUFACTURED ~'i'RUCTLIRE STATE FEE <br />MANUFAC'rUREO STRUCTURE STATE ,~URCHAR~E <br /> <br />TOTAL ~E~ED FEES <br />PRE¥IOUS RECEiRT~ <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />A~0UNT <br /> $~82·00 <br /> $20.00 <br /> $9.10 <br /> <br />$211.10 <br />$o.oo <br />$211.1o <br /> <br />BALANCE DUE $0.00 <br /> <br /> THiS IS NOT A PEt~,qlT. THIS APPLICATION MUST 6OTHROUGH A REVIEW PROCESS I,'~ERE THE ~OLLC~i~ <br />t4UST 8E COMPLETED. iT IS THE RESPONSIBiLiTY OF THE APPLICANT TO A.SS.URE THAT ALL NECEE.%_%~RY <br />INFORI~iATiON HAS BEEN PROVIDED+ <br /> <br />SEP'TiC: BY ................................................. DATE .............................................. CiTY JURISD~C'f'iON: BY ............................... DATE ............................... <br /> <br />ZONING: BY DATE SE'FSACK~ PR 10 L~ 15 RS 15 RR 10 ~P <br />REMARKS: ~0B~EE'"'ROME ........................ <br /> <br />PLANNING ACTiON: <br /> <br /> OFFICE COPY <br />FORM ~ MD 15-~6 RE',/. 4./90 <br /> <br /> <br />