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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 />DA'rE: 05/20/92 <br /> <br /> L,~A, HARVEY <br /> <br />'1- ,[ F'4~: 15:23;41 <br /> T~X' ~O?: ! 0ATEGORY'. <br /> RES! DENT <br /> <br /> .......CONSTRUCTION ~E: , O~CUPANCY; <br /> : <br /> <br /> 10253 MILL CREEK ROAD SE .......... ,0CCUPA~ LOAD: <br /> AUMSV.~ LL.E OR 9?325 'i CONTRACT CITY: ii UGB'. <br /> : MARION COUNTY NO <br /> <br /> MANU~AQ;:~BED S'~RUC' ;UBE 3 <br />: MA~L~N~ A~DAESS; , SUBDIVISION: <br /> <br /> PHONE_' ,!5ITE NUMBER: 92-0'1922 <br /> VALUAT iON: <br /> <br /> SLOCK: SECTION: TOWNSHIP; i RANG~; ' ZONe: ; MAP; <br /> ', 3t 8~ , qW ~ RA 48 <br />WISTH: 12'~DEPTN:. 352 AREA; UNITS: SF IRREG, LOT~ <br /> yE~CORNER~o <br /> <br />TYPE: MANUFAC'iUREO $']'RUC]'URE PERMIT OR APPLiCA"F.[ON NO: <br /> <br />CONFEt. ACFOR, NO. 39990./"% <br />Mont;e Mff'ller~ [ I ~-'~..~'-,,.~ ~.f.~ <br />5818 S~ Cou,?,s Rd ",-~/. . ~ -~ <br /> <br />PHONE: 000-0000 ~ ~ ~' <br /> <br /> I T E~ <br />~UFAC'f'UA~O S'I'~C'f'URE P~CENEN'f'/C~NEC'fi~ <br />MANUFACTURED S[~C'TURE STATE FEE <br /> <br />MANUFACTURED 5TRUC'fURE ZONING ~URCHARGE <br /> <br />9040105 <br /> <br />1:OTAL ~ED FEES <br />PREVIOUS RECEIPTS <br />THiS RECEIPT <br /> <br />QUANI'If'Y <br /> <br />AMOUNF' <br /> $182.00 <br /> $20.00 <br /> $9~10 <br /> $~5,o0 <br /> <br />$o,oo <br /> <br />BALANCE DUE $0.00 <br /> <br />PAYEE: M & rg CONSTRUCT~ON RECEIP'I 42152 , <br />RECE. IV~O BY: D1'42 ......................................................................................................................... TYPE: OK CHECK. ~: 2542 <br /> <br />:* THIS IS NOT A PEE/vliT. THiS APPLiCAT.[ON MU'AT GO THt;L~3UGH A REV:[EI~ PROCESS tHHERE THE FOLLO~IN <br />~¢[JST BE COMPLETED. iT IS THE RESPONStI~.[L.[TY OF THE APPLICANT TO ASSURE THAT ALL NEC~E,,SARY <br />INFORI~4ATJ(ON HAS ~EEN PROViD£t3. <br /> <br /> OFFICE COPY <br />FORM # MO 15-56 REV, <br /> <br /> <br />