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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 />I am a registere,~ builder OR { ) the authorized representative <br /> <br />The work will be performed by :~ registered builder. <br />Other <br /> <br />OATE: 09/08/92 TIME: 8:14:04 <br /> <br /> ~i~44 JAMES ~AY SE <br /> ~ !OCCUPANT LOAD: <br />AUMSVILLE OR <br /> <br />52~0 RZVER RO~D N ~000 <br />KEIZER 97~05 OFFICE 59~-~624 X-350 <br />PHONE; 590-9555 VALUATION: <br /> <br /> [ ~ 29 8S ; 1W AR ; 48 <br /> <br />TYPE: MANUFACTURED STRUCTURE <br />CONTRACTOR, NO. 23~S3 <br /> Le~sureland Mobile Homes Inc <br />PO Box 5400 <br />Salem, 97304-0400 <br />PHONE: 299-0127 <br /> <br />PERHIT OR APPLICATION NO: 9042399 <br /> <br />ITEM <br />MANUFACTUREO STRUCTURE PLACEMENT/CONNECTION <br />MANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARSE <br />MANUFACTURED STRUCTURE ZONING SURCHARGE <br />MANUFACTURED STRUCTURE TURNPIKE O/W BUILDING INSPECTIOH <br />HANUFACTURED STRUCTURE TURNPIKE D/W PUBLIC WORKS <br /> <br />TOTAL ASSESSED FEES <br />PREVIOUS RECE, IpT8 <br />THIS RECEIPT <br /> <br />QUANTITY <br /> <br />RNOUNT <br /> $182.00 <br /> $20.00 <br /> $9,10 <br /> <br /> $1.0P <br /> $16.00 <br /> <br />$243.10 <br /> $0.00 <br />$243.i0 <br /> <br /> ~ BA~'ANCE DUE $0.00 <br /> <br />PAYEE: ROSE, FRANKLIN '~) RECEIPT <br /> 44464 <br /> <br />* THIS IS NOT ~ PERMIT. THIS APPLICATION HUST 60 THROUGH A REVIE# PROCESS ~HERE THE <br />FOLLOWING MUST BE COMPLETED. IT. IS'THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THAT ALL NECESSARY [NFORHATION HR$ BEEN PROV[DEDL <br /> <br />PLANNZN~ ACTION: ~C*~ <br /> PLaN REVIEW:~Y_ <br /> DATE <br /> ZONING: BY ~2 ....... <br /> SEPTIC: ~Y::~Z:ZZZZ <br /> <br /> CITY JURISDICTION: BY DATE <br /> REH~RKS: HFG <br /> <br />SETBACKS: FR,~ <br /> RS ?-~P- <br /> RR~.~ <br /> <br />OFFICE COPY <br /> <br /> <br />