Laserfiche WebLink
I"FOR ~FFICE USE ONLYI <br /> Received by:~ <br /> Zoning Valid~a~iofl '~ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> <br /> 220 High Street NE <br /> Salem, OR 97301 <br /> g:~0 am ~:30pm Fnone 5S8-5147 <br /> Oxle-A.Phone 588-7904 <br /> FA~ 588-7945 <br /> MANUFACTURED STRUCTURE PLACEMENT <br /> <br /> PERMIT APPLICATION <br />COMPLETt~ ALL SECTIONS, I THROUGH 4 <br /> )'Ob Descdpti0n <br /> <br />[FOR OFFICE USE~_O.NLY <br />/ C'ity Setbaok Requireme~lts: <br />[Front'. ~ ' }Rear-, <br /> <br />]lDfftSide: ~/,~.q-! , }Pdght Side: ~-/ <br /> <br />Location of Installation <br /> <br /> " ' ~ ]Bilk Urban G~wth g~unda~? <br />Subdivision ,~ <br /> ....... ~ PrlvateWc~ ( ) Sprig ( ) <br /> <br />If I change my mind and do him a general contractor, I will contract w~th a contractor who is registered with thc Coostmction Contrado#s Board, and will <br />immedlalely notify Ma~on County of the name of the contractor, <br /> <br />(/Q I am a regmemd builder OR thc authonzexl representative of a regastemd buildm-. <br /> <br />4. Fee Schedule <br /> <br />A. (1) Manufactured Home <br />or Modular Unit Placom~alffCcone~ion @ $182.~ = <br />(2) StateFee ~ ~ 20.~= ~,~ <br />(3) State Surcha~e ~ <br /> <br />g. (1) Mfg.'d Stmcmm S~rag~ Fee <br />(g) ~g.'d Stmem~ S~ge Renewal ~ 25,00 ~ __ <br />(3) ~nlng Su~cha~e (15,~ ff a~cable) ~ 15.~ ~ __ <br /> <br />C. Additional Inspection (~ $60.130 :-'__ <br /> or Reinspection <br /> <br />D, Invest~ation Fee <br /> <br />E, Other inspections not llsted <br /> ~ 4o,oo r~r hour (2 hour mln~mum) <br /> <br />~) $40.00 =__, <br /> <br />TO'IAI,= $,,,o'~O,~/?. F-/Jt~ <br /> <br />NameofApphcant(pleasepdllt): ! I}~f'~tn,. ?'xj~fl~l Phone: <br /> <br /> <br />