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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 /> [ am e registered builder OR the authorized representative <br /> <br /> Other .... <br /> <br /> DATE: 05/18/94 rtHE: 14:e7:21 <br />81TUB ADDRESS; <br /> <br />SI~NATUR~ O~ APPLICANT .. ~"~"~ ~ <br /> <br /> OONST~UCTION TYPE; I OCCUPANCY; <br /> 11658 ~ARBI. ER LN NE ' <br /> nu~o~A on ~7~ ~i:~i~'~'~'""'~?~ .................... 'o~'~^~ <br />us~ o~ ~U~L~uFACTURE~ ~TRUCTURE .................................................. T~E'~ ~'~oous <br /> ~--.-~-~.,. ....................................... ~ ........................ , ..................... ~_~_...~. ....................... <br />MAILING ADDRESS~ SUBDIVISION; <br /> CENTURY HEADOWS PH 4 <br /> 1~205 SE SUNNYSIDE RD <br /> PORTLANB OR 9Z~15 ~ m~ ..................................... <br /> PHONE= &52-22&B p~ y~y , VALUATION:SZTE NUNBER~ <br /> <br /> .... .... ............. ......................... <br />' TYPE= NANUFACTURED STRUCTURE PERHIT OR ~PLICATZON NO: 9E55143 <br />CDNTRACTOR~ NO. <br />Cascade ~cktng <br />11~5 Cascade Hw~ SE <br /> <br /> PHONE: 588-~254 <br /> <br /> ITEM ,/ ........ ,' ............ ~ '~"~' ;- ~'' .......... <br /> N~NUFACTURED STRUCTURE PL~CEHENT~CONNECTZON <br /> HANUFACTURED STRUCTURE S~ATE FEE <br /> MANUFACTURE~ STRUCTURE S~flTE SUR~ <br /> NANUFACTURE~ STRUCTURE ZONZN~ <br /> <br />PAYEE: Cascade <br />RECEIVED ~Y= <br /> <br />~ THIS IS NOT <br />FOLLONING <br />THAT ALL NECESSARY <br /> <br />rYPE:,:' CA <br /> <br /> QUANTITY AHOUN'T <br /> $182.~0 <br /> $20.00 <br /> $9.10 <br /> $15.00 <br /> <br /> $226.10 <br /> $0.00 <br /> $22~.10 <br /> <br /> $0.00 <br /> <br /> RECEIPT 57614 <br /> CHECK ~= 0 <br /> <br />REVIE~ PROCESS WHERE THE <br /> APPLICANT TO ASSURE <br /> <br />PLANNING ACTION." , <br />P~AN REvz~..: ~,*,' ...... ~£:... <br />ZONING: SY ..~:(~.__~ <br /> SEPTIC: BY ...... ~'- .............. DA ___~ <br /> CITY JURISglCTION: BY .......... ~ATE <br /> REHARKS: th,- ~) .... :: <br /> <br />SETBACKS: F'R I D <br /> LS-'--~' <br /> <br /> SP <br /> <br />FORM # MC l~-e6 RSV. 'q/~ OFFICE COPY <br /> <br /> <br />