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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 /> P4 HOUR CODE-A-PHONE: 588-7904 <br /> <br />I am performing work on 8 properly I own or OCCUDy. <br /> of a Ge~istered buil~r, r I ' b r <br />~ ~ e~° "k'l have readWillandbe agreePe ormedto thebYStermsegstated~ter~don uilde .the rever~e" side of <br /> <br /> O "t~ LO~: <br /> OV~R~ZELD, ~ARK <br /> <br /> ~NUFACTURED STRUCTURE <br /> <br />HUBBARD OREGON 97032 i SITE NUMBER: 94-00801 <br />PHONE: 981-7j. 87 I VALUATION: <br /> <br />CONTRACTOR, NO. <br />OVEREIESD. MARK <br />PO BOX 239 <br />~UBBARD OREGON 97032 <br />PHONE: 98t-718~ <br /> <br />PER~IT O~ APPLICATION NO: 9053137 <br /> <br />NANUFACTURED STRUCTURE PLACEMENT/CONNEC~ION <br />M~NUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE:SURCHARGE <br />MANUFACTURED STRUCTURE ZONINGSURCHARGE <br /> <br />PAYEE: OVERFIELD, HARK <br /> <br />QUANTITY <br /> <br />AMOUNT <br /> $t82.00 <br /> $20.00 <br /> <br /> $:5.00 <br /> <br />TOTA~ ~SsEsSED FEES $226.10 <br />?RESIDUE:RECEIPTS, $0~00 <br />THIS::RECEIP? $226.i0 <br /> <br /> $0.0o <br /> <br />RECEIPT 5559& <br /> <br />RECEIVED BY: D~2 :: : ';: ::?¥PE~: CK C~ECK #: <br />* TEIS IS NOT A PERNIT~ REVIEW PROCESS W~ERE TEE <br />FOLDOWIN6 NUST BE ! THE APPLICANT TO ASSURE <br />TEAT ALL NECESSARY INFORNATION, EASYBEENi~ROVIDEDi <br /> <br />PLAN REVIEW: BY , <br />ZONING: BT~f~L DAT~_._~¢~-- <br />SEPTIC: BY <br /> <br />C:TY JURiSDiCTION: BY DATE <br />E~,MARK$. MFG MOME/AUT~ ?UE~}(H ~NC~OS~D <br /> <br />SETBACKS: FR ~ O <br /> RR ~ <br /> <br />u ~ uc t~-~ .~.'.,~l~ OFFICE COPY <br /> <br /> <br />