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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG. NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br />I I of a registered builder, <br /> I am a registered builder OR"~f~the authorized resresentat~ve <br />('"~"l Other , ,, <br /> <br />;.eWNEn: DATE: 02/18/94 TIME: 8:49:34 <br /> WALLACE, ROBERT & VALARIE <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 588J904 <br /> <br /> SIGNATURE OF APPLICANT; <br /> <br />TAX LOT; ~, ~AYEGORY: <br />73500-220 ~ RESIDENTIAL <br /> <br /> AU~SViLLE OR 97325 ~MARiON COUNTY}NO <br />: XANUFACTU~ED STRUCTUR~ 2 <br /> <br /> SA~E <br /> SiTZ ~ER: 94-00725 <br /> PSONE: 769-3252 VALUATION: <br /> <br /> , ~ 0.61 ~ AC : YES ~ YES <br /> <br />TYPE: MANUFACT~RD STRUCTURE <br />CONTRACTOR, NO. 38235 <br />Daniel L Carver <br />11373 Mill Creek Rd <br />Aumsville, 97325-0000 <br />PHONE: 769-7744 <br /> <br />PERMIT OR APPLICATION NO: 9053009 <br /> <br />ITEM <br />HANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />NANUFACTURED STRUCTURE STATE FEE <br />MANUFACTURED STRUCTURE STATE SURCHARGE <br />MANUFACTURED STRUCTURE ZONINGSURCHARGE <br /> <br />'TOTAL ASSESSED FEES <br />:PREVIOUS RECEIPTS <br />THIS RECEIPT <br />:BALANcEDuE <br /> <br />QUANTITY AMOUNT <br /> $182.00 <br /> $20.00 <br /> S9.i0 <br /> $15.00 <br /> <br />$226.10 <br /> $0.00 <br />$226.10 <br /> <br />$0.00 <br /> <br />PAYEE: ROBERT & VAAAz.R]]~2_gALLACE: :: . RECEIPT 55469 <br />RECEIVED BY.. MB 1/ ]/% ~__~_%~ CE CHECK #: 1430 <br /> <br />* THIS IS NOT A PERMIT. a REVIE1/ PROCESS NHERE THE <br />FOLLOWING FJST BE CO~PLETED~i::IT IS::TB'~, RESPOMSIBILITY~OF THE APPLIC~T TO ASSURE <br />T~T ALL NECESSARY INFOR~TIONHAS BEEN;PROVIDED~ <br /> <br /> PLANNING' AC?ION: ,~ ~¢-- nJ¢ / <br /> PLAN REVIEW. BY///~//'DATE~¢~ ~'~Z~ SETBACKS: FR <br /> ZONING! BY .,O,~'f~ ( ...... DATE ~5.¢ ' ¢~ l <br /> <br /> CITY JURISDIC~ DATE SP <br />Mc ~e-~6 ~, ~ O F iFI C E COPY <br /> <br /> <br />