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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 />DATE: 07/14/92 TIME: 10:30:27 <br />MOZZILLO, GRE6 57706~000 ~ RESIDENTIAL <br /> <br /> 280 EVERGREEN OR 8 I <br /> HANUFACTURED STRUCTURE <br /> <br /> SAME ~ EVERGREEN ESTATES HH PARK <br /> ~ SITE NUHBER: 92-03255 <br /> PHONE: 399-7810 ~ VALUATION: <br /> <br /> ~ 25 88 2W i RH <br /> NO <br /> <br />TYPE: MANUFACTURED STRUCTURE <br />CONTRACTOR, N0.'38238 <br /> Santiam Homes <br />12373 Hill Creek Rd <br />Aumsville. 97325-0000 <br />PHONE: 769-7744 <br /> <br /> ITEH <br />NANUFACTURED STRUCTURE PLACEMENT/CORNECTIOH <br />HANUFACTUREO STRUCTURE BTATE FEE <br />MANUFACTUREO STRUCTURE STATE SURCHARGE <br /> <br />PERHIT OR APPLICATION NO= 9042521 <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> $9.10 <br /> <br /> TOTAL ASSESSED FEES $211.10 <br /> PREVIOUS RECEIPTS $0.00 <br /> THIS RECEIPT $211.10 <br /> <br /> , BALANCE DUE $0.00 <br />PAYEE: Santiam Homes :!:, . INVOICE. 44588 <br />RECEIVEO BY: PB ::: TYPE', IN CHECK 5. 0 <br />· THIS IS ROT A PERHIT. ::THIS APPLICATIOfl HUST 60 THROUGH A REVIE# PROCESS WHERE THE <br />FOLLOHING HUST BE COMPLETED. IT IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THAT ALL NECESSARY INFORHRTiON HASBEENPROVIDED. <br /> <br />PLANNING ACTION: <br />ZONING: BY .......... DATE <br /> <br /> CITY JURISDICTION: 8Y DATE <br /> REMARKS: MO8ILE HOME <br /> <br />SETBACKS: <br /> <br />FR 10 <br /> <br />RSZlS <br />RE_lO <br /> <br /> OFFICE COPY <br />FORM # MC 1~,$6 R~V, 4/90 <br /> <br /> <br />