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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: 88- ,47 8:80-4:30 <br /> <br />will b~ performed by a r~O~tered builder. <br /> <br />owN~AATE: 04/22/99 <br /> <br />TAX LOT: <br /> <br />~ONS'r~uc~']ON TYPE: <br /> <br />, OCCUPANCY: <br /> <br /> 11684 LARK COURI <br />AURORA OR 9?002 <br /> <br />~ONT~ACT CITY: ' <br />MAR'iON COt~NTY NO <br /> <br />;OCCUPANT LOAO: <br /> <br />SUBDIVISION: <br /> <br /> 90 WALKING ~EYOO OR <br /> LAKE OSWEGO, OR <br /> PHONE: 635-7918 <br /> <br />LOT'. Bt_O0 ~i SECTION; <br /> <br />CEN'I'UR¥ ~EAE)ONS NO 4- <br /> <br /> SiTE NUlV~3ER: 92-0]584 <br /> VALUA'[ ,[ON: <br />RANGE: ZONE: <br /> <br />MAP: <br /> <br />3 <br /> <br />W~b~H: 24 [:)EPfR: 19 AREA; 33 ' :uNrrs: <br /> 55 85 5525 <br /> <br />3~ ': tRREG. LOT; 'fin CORNER; <br /> <br />SE ' . NO: NO <br /> <br />TYPE: P4ANUFAC'f'LIREO BTRUC'FURE PERMi'f OR APPLiCATiON NO; <br /> <br />CONTRACIOR, NO. 73977 <br /> L$C4A I N CONS'f'RUCT ,( ON <br />208 SE 4TH <br />'f'ROU TDALE, 97060~0000 <br />PHONE: <br /> <br />~ANUPAC'f'UREO S'f'N'tJC'f'URE PLACEMELN'f'/CONNEC'f'iON <br />~ANUFAC'ruREB ~'1'RUC'i'URE STAI'E FEE <br />~ANUFAC'f'URED STRUCTURE STATE SURCHARGE <br />MANUFACfUREB STRUCTURE ZONZNG SURCHARGE <br /> <br />TOTAL A~ES,~'EB FEES <br />PREVIOUS RECEIPTS <br />'f'HIS R~CEIP'I' <br /> <br />PAYEE: GREEN, JOE <br />RECEIVED BY: CL <br /> <br />9039540 <br /> <br />QUAN1'iTY AffiOUN¥' <br /> $182.00 <br /> $20.00 <br /> $9, lO <br /> $15.00 <br /> <br />$225.10 <br /> $o.0o <br />$226.q0 <br /> <br />BALANCE DUE $0,00 <br /> <br /> RECEIPT 41589 <br />'TYPE: CK CHECK ~: 41586 <br /> <br />* THiS IS NOT A PERMIT. THZ~ APPLICATZONfvlUST GO THROUGH A REVIEW P,c~OCE,~.~ ~'~-iERE THE FOLLONIN <br />~LIST BE COffiPLETED. iT 1S THE RF_..~PCN~IBiLiTY OF THE APPLICANT TO ~RE THAT ALL NECE'$~C. RY <br />INFORMATION HA~ BEEN PROVIDED. <br /> <br />SEP'f'JC: ~IY DATE Ot'['Y JURiSOfC'TION: BY DATE <br /> <br />REIV~ARK$: ffiFG-t~O~?: ............... 7 ............................................................ <br />~->L, ANN ING AC ~ ._ON: <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV. <br /> <br /> <br />