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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 C;QDE-A-PHONE: 588-7904 <br /> <br />o¢ a registered builder, <br /> <br />Other <br /> <br /> ~ATTS, ~R'.I'.AN H , ~ 587492~&~4 ~RES~EN'f~AL <br />; ........~/]~SV:U.J.E OR 9?325 NA~ON CO. qTY ~O ' <br /> <br />:TYPE: ~ANBFACTUREDSTRBCTURE <br />bONIk~, fOE. NO,, <br />W~T~S~ ~K~AN h <br />SANE <br /> <br /> 2. AC NO NO <br /> <br />PERMIT OR APPLICATION NO: ?057549 <br /> <br />F'HONE: 749--~.495 <br /> <br />NAI,IUF'ACTURED STRUCTURE PL. ACEMENT/~.'ONNECTION <br />MANUFAC1 JREt) STRUCTUF~L." STATE FIi~E i <br />:MANUCACTUREI) 9TRUCTURE ,STATE SURCHARGE <br />MANUFACTLJRED SI'RUCI'URE Z0bilNG SURCHARGE <br /> <br /> J ]TOTAL ASSESSED EEES <br /> :: 8R~'.;~ ~ OUS RECE I PTS <br /> ~1,~! o RECEIP:[ <br /> <br />PAYEE :~ <br />,RL-':CE:D,/E~) BY;~ mb <br /> <br />QUANTITY AMOUhtT <br /> $:L82.,~0 <br /> <br /> $9~10 <br /> <br /> 1~22~. :LO <br /> j I~ECEIPT <br /> , : TYPE: CHECK ~,: 0 <br /> <br />~ TH.tS IS N~T ~ PER~IT. TH~S'APPE~C~TION NUS~, 6~ ,,THROUGH ~ REV~E~ PROCESS ~NERE ZHE <br />FOLLOWIN6 HUST BE COHPLETE9; OF THE APPLICANT TO <br />THAT ALL NECESSARY iNFORmaTION H~$ BEEN <br /> <br />SET[tACI(S: [~/Ol~¢ <br /> S F" .............. <br /> <br />PO~. MC '~-se R~, ,~/~ OF FICE COPY <br /> <br /> <br />