Laserfiche WebLink
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 /> h~ve eaC"and agree, to~'e terms crated on the reverse side of DATE: <br /> <br /> DA'f E: 04/,.2/92 'f IME: b~5 ?.(;8 <br />OWNER; TAX LOT: CATEGORY: <br /> GREEN, JOE 7055'1191 <br /> <br />iRES I DEN') <br /> <br /> q1695 THRUSH COUR'f -- <br />ADRORA OR 9'7092 <br /> <br /> P/tANU FAC'f'U RED. ~:l: RU~ t:U RE <br />MAILING ADDRESS; <br /> <br />20 WALKING Need OR <br />LAKE OWSEGG, OR 9'?035 <br />PHONE: 636-7918 <br /> <br />cdN~RAC~ciTY: "Ute: <br />:f4ARIDN COUNTY: <br /> <br />59 <br /> <br />OCCUPANT LOAD: <br /> <br /> NO OF BEDB00MS: <br /> <br />SUbDIVISIOn; <br /> <br />CEN l RL RY ~VlE,A, OOONf,5 NO4 <br /> <br /> SiTE NUMBER: 92~01582 <br /> VALUAI' iON: <br />LO~'. : BLOOKi .... SECTION: '¢~W~HiP: RANEE: :ZONE: MAP: <br /> <br /> 33 3~ lW <br /> ~REA; UNI~: : IRREG. LOT: ~0RNER: <br /> '100 5900, SF ' NO NO <br /> <br />I'YPE: IMANUFA.CTURED STRUCTURE PERM,' OR APPLICATION NO: 9039534 <br /> <br />CON'f'RAC'fOR, NC)- <br />GREEN, JO~ <br />20 ~ALKiNG WOOD OH <br />LAKE C'~'~EGO, OR 9?035 <br />PRONE: ~36~7918 <br /> <br />I'I'E~ <br />~ANUFAC'f'DRED S'f'R~CTURE pLACE~EN'f/OONNECT~ON <br />~ANUFACTURED ~']'RUC'I'URE S'I'AI'E FEE <br />MANUFACTURED STRUCTURE ~'¥'ATE ~B,J~%:HARGE <br />MANUFACTURED S~'RUC'f'URE ZONING SURCHARGE <br /> <br />QUAN'T'11Y <br /> <br />,,~IOUN']' <br /> $182,90 <br /> $20_00 <br /> $9_!c <br /> <br />'lO'['AL ~E,%SGED FEES <br />PREVIOUS RECEiP']'S <br />THIS RECEiP'I <br /> <br />$225.10 <br /> $o_oo <br /> <br />BALANCE DUE <br /> <br />PAYEE: JOE GREEN RECEIPT 41583 <br />RECEIVED BY: CL TYPE= CK CHECK ~; <br /> <br />~ THIS i$ NOT A PERI~iT. TH~$ APPLICATION ~J~T 60 TBRO~EH A REVIEN PROCES~ ~ERE 'fH~ FOLL~I~ <br />~S'T' BE ~PLETED. iT IS THE R~SiBiL[TY OF THE APPLiC~T 're ~RE THAT ALL NECE~RY <br />[NFO~TI~ H~ BE~ P~iOEO. <br /> <br />~EP'I'iC; BY ............................................... DATE ........................................................ CZ'f'Y JURISOiC'fIGN: BY ............................... DATE ......................... <br /> <br />,/.GN~,NG~, BY---:~'~''- DATE ~Zt~-~.'z SE'T'BACK~: FR ~'~ kS <br />REfVlARK~ '- ~4FG" P~CE~EN'¥ ....... <br /> <br />F>LANN ING AC l ION: <br /> <br /> OFFICE COPY <br />FORM # MC 15-56 REV, 419(~ <br /> <br /> <br />