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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 />of a registered builder, <br />The work will be performed by a registered builder. <br />Other <br /> <br /> ADDRESS: <br /> <br /> , SITE NU~B/R: 94-~1579 <br />WIDT~ ~ ?EPTH; AREA;4 ~ UNITS~'~5 IRR~ LOT'. <br /> <br />TYPE: MANUFACTURED STRUCTtlRE <br />CONlkAC~OR,, NO. 92549 <br />CAN PBI.:],_ L HOHES <br />7911 SQUJ[RRL'L H]].L <br />,~hl., ..N~ <br /> <br />PER~IT OR APPLICATION NO: 9g§4427 <br /> <br /> TEN <br />HANUI-"AC, TORED STRUCTURE F'L.ACENEt,~i/CONNECT):ON <br />i'itGHUF'AI]'FUI'~[.~D S[ROCTURE S'T~TE FEE <br />liANUFACTUREB S'TI~OC'iUR. E STATE SURCHARGE <br /> <br />QUANT ITY <br /> <br />A~iOUNT <br /> $182.00 <br /> $2r& ~0 <br /> $?. I0 <br /> <br /> TOTAL: ASSESSED FEES $211,, 10 <br /> Pi.~EV:[OUS RECE.'/PI'S <br /> TH)/S RECEIPT $21I,, <br /> : ~ BALANCE DUE $~,, <br /> <br />Rk(:E.~VE:D BY: HB ~.2....L.._,..Z_LZLZ//,~;:~:~.~:~ T~P~: Ik CHECK ~: <br />* INIS i~ NOT A PERMIT. GO THROUGH A REVIEW PROCESS WHERE THE <br />FOLLOWING MUST ~E COMPLE'T/D. IT ;IS THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THAT ALL NECESSARY INFORMATION: H~S BEEN PROVIDED~ <br /> <br />SETBACKS: FR lB <br /> LS-'15 <br /> RS-"i5 <br /> RR'-'i5 <br /> <br />rOAM # MC l~5,~e R~¥, ~/~0 OF FIC E COPY <br /> <br /> <br />