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MARION COUNTY BUILDING INSPECTION <br />SENATOR 8LDG 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: 588-7'904 <br /> <br />Other <br /> <br /> I)ATE: 10/07/9~ TIME: 11."20:21 <br /> <br />°wN~":SANTZ'AH HOMES T*XLOT: c~L~ENTiAL <br /> <br /> 2].§ BELLEVUE DR -- S3: .................. <br /> AUMSVILLE OR ?7325 ' ~Bj~ U~ ;OCCUPANT LOA~' <br /> <br />MAILING <br /> <br /> AGENT: CRAIG LUCAS~SANTIAM HOMES <br /> PHONE; 76~,-7744 VALUATIOM~ <br /> <br /> TYPEs HANUFACTURE~ STRUCTURE PERHIT DR APPLICATION NO: <br /> COHTRACTOR~ MO. <br /> De~e! L Ca~ve~ <br /> ~1373 M~ll C~eek Rd <br /> Au~sv~lle~ ¢732~-0800 <br /> PNONE. 7&~-7744 <br /> <br /> ~TEM QUANTITY AMOUNT <br /> MANUFACTURED STRUCTURE PLACEMENT/CONNECTION $182.00 <br /> MANUFACTURED STRUCTURE STATE FEE $20.00 <br /> MANUFACTURED STRUCTURE STATE SURCHARGE <br /> <br /> TOTAL ASSESSED FEES $211.10 <br /> PREVIOUS RECEIPTS $~.00 <br /> THIs RECEIPT $~11.10 <br /> <br /> ANCE DUE $0.00 <br /> PAYEE: Del ?Cor~ick ~ INVOICE. 5278& <br /> <br />PLANNIN~ ACTION: <br /> PLAN REVIEW: BY ~ DATE IO-~ <br /> ZONING: BY .......... DATE ............ <br /> <br /> CITY JURISDICTION: BY ........ ~ATE ........... <br /> REHARI(S: MFG HOME <br /> <br />SETBACKS: FR 11 <br /> LS-15 <br /> RS-15 <br /> RR-10 <br /> <br /> OFFICE COPY <br />FORM # MO 1 $-~ REV. <br /> <br /> <br />