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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: 588-514,7 8:00 - 4;30 <br />24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> of a registered builder, <br /> The work will be performed by a registered builder, <br /> Other. <br /> <br /> OATE: 09/22/92 <br />!owNer':MEYER. JUDY <br /> <br /> 3].0 EVERGREEN <br /> AUMSVILLE <br /> <br />SIGNATURE OF APPLICAN'¢: <br /> <br />:Uss bF au~L°~NUFAOTURED STRUCTURE <br /> MAILING ADDRESS; ! SUBDIVISION: <br /> I EVERGREEN ESTATES <br /> SAME <br /> ~ SITE NUMBER: 92-03388 <br /> PHONE: ! VALUATION: <br /> <br />:WIDTH, SS ?EPTH, 90 iAREA: 4950. iUNI~ [ '~, LOT; <br /> <br />TIHE: 12:~9:42 <br /> <br /> / b//06-O00 <br /> : RESIDENTIAL <br /> <br /> OCCUPANCY: <br /> ~ R~ <br /> OR 97525 "~¢J~T§~JrLC~T~; i ~' ;OCCUPANT LOAD: <br /> <br />TYPE: NANUFACTUREO STRUCTURE <br />CONTRACTOR. NO. ~82~8 <br /> Santiam Ho~e~ <br />~S75 NJ11 Creek Rd <br />AumsvJlle, 97325-0000 <br />PHONE: 769-7744 <br /> <br />PERMIT OR APPLICATION BO: 9042730 <br /> <br />ITEM <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUOTUR~ STATE FEE <br />MANUFACTURED STRUCTURt STATE SURCHARGE <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 /> THISRECEIPT $211.10 <br /> : BALANCE ~UE $0 O0 <br />PAYEE: CRAIG LUCAS . ~--,"" ;. ::!.::: : INVOICE 44788 <br />RECEIVED BY: P8 ~].:. : : i ]:!.!!'Z :.::~ ' '" TYPE: ~N CHECK ~: 0 <br /> <br /> APPLICANT TO ASSURE <br />THAT ALL NECESSARY INFORHATION'NA~BEEN:PROVIDED:~ <br /> , <br /> <br />SETBACKS: <br /> <br />FR 10 <br />LS-15 <br />RS~15 <br /> <br />SP .... <br /> <br />PLANNING ACTION: /¢~/''''' · ..~ _,,~'~- <br /> PLAN REVIEW: BY ~..,~.~_. BATE .,~¢~_~.~"Z',_~.~--~ <br /> <br /> SEPTIC: BY .... Z~ZZ] .... DATE .... -~ ...... <br /> <br /> CITY JURiSDICTI'ON: 8Y DATE .... ~ .... <br /> REMARKS: MOBILE MOHE F[~T <br /> <br />POS~ ~ MC ~-~ RSV, ./~o OFFICE COPY <br /> <br /> <br />