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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 g,m 8 recjistered builder OR ( ) the authorized representative <br />of a registered builder. <br />The work will be performed by a registered builder, <br />Other ...... <br /> <br />SI(~NATURE OF APPLICANT;~_~' <br /> <br />HAS(.141xE,~ LES & BETTY I ~o~c~X~b~NfIAL , <br /> <br /> , ~ ~... ~': 3 ; <br /> <br /> AURORA OR ~7~2 ~ MARION COUNTY NO j <br /> <br /> ~ANIJI-ACTURED STRUCTURE ~ E~ <br /> <br /> PSRTL~N~ 8R 972~7 HDBIL. E 79~"-1~5B , SITE NUMBER: ~-02655 , <br /> PHONe: 289-6962 ~ VALUATION: ~ <br /> <br />TYPE: HANUFACTURED STRUCTURE <br />CON'TR~CTOR. NO. <br />MASCHKE. LES & BETTY <br />2201N ~ENZIES DR <br />PORTLAND~ OR 97217 MOBILE 799-1 <br />PNONE: 289-6962 <br /> <br />PERMIT OR APPLICATION NO: 904884~ <br /> <br /> ITEM <br />HANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />HANUFACTURED STRUCTURE STATE FEE <br />HANUFACTURE~ STRUCTURE STATE SUR£HA~GE <br />MANUFACTURED STRUCTURE ZONING SURCHARGE <br />MANUFACTURER STRUCTURE OlJ~B'QZW BUIL$ING INSPECTION <br />MANUFACTUREB STRUCTURE CURB O/W PUBLIC WORKS <br /> <br />TOTA~,.ASSESSE9 FEES <br />PREVIOUS-~RECEIPTS <br />TH,IS"RECEIPT ,, <br /> <br />BALANOE DUE <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.98 <br /> $~.10 <br /> $15.00 <br /> <br /> $7.00 <br /> <br />$,~ ~'~. ~0 <br /> <br /> $8.00 <br /> <br />RECEIPT ~1166 <br /> <br /> ~AYEE: MASCHKE, LES & BETTY <br /> RECEIVED ~Y: PM ............................................. TYPE: CK CHECK $: 2400 <br /> · THiS IS NDTA PEEHIT. THIS,~PLICATI~ ~UST',GD THRDUGH ~ ~EVIEW PROgEBS WHERE THE <br /> FOLLOWING MUST BE COMPLETED. IT IS THE RESPONSIBILIT~ OF THE APPLICANT TO ASSURE <br /> THAT ALL NECESSARY INFORMATION, HAS BE~ PROVIDED., ~' [0 ~-.~ ~~ <br /> <br />LANNIN6 A(,llON: <br /> <br /> SEF'T I{',: [:4Y ....................... RS-" ~, <br /> ......................................................................... <br /> CI'fY ¢ 'c ..... <br /> JU ~]., D,t, CT].ON,. BY ~A'rE sP ......... <br /> EL. MAMbo., H!~ P_ACE4ENT-O~E¥'"::;-,O P.~ ~ ~OR OARPOR f OR SHED <br /> <br />~oRr~ ~ r~ ~-~ ~v, 4~ OF FICE COPY <br /> <br /> <br />