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MARION COUNTY BUILDING INSPECTION SENATOR BLDG. NO. 225 220 HIGH STRI=ET NE SALEM, OREGON 97301 PHONE: 588-5147 8:00 - 4,:30 24 HOUR CODE-A-PHONE: 588-7904 Other 5671 VILLAGE VIE~ CT SE ~ ................... ~'~' 6~ ~O1~UF~CTUR~9 .............................................................STRUCTURE i ................... PO BOX 647 ~, AUHSVILLE OR 77~25 ~ SITE NUMB/R~ 94-~441~ PHONE= 74~-~7~4 . VALOATION: i 18 8S 1W i AR ;4]. TYPE". MANUFACTURED STRUCTURE CONTRACTOR~ 1t0. 23:3:33 Leisureland Mobi].e HoMes PO Box 5400 SaleM~ 97~04-04~0 PHONE." 377-0127 ITEM HANUF'ACTUREB STRUCTURE PLACEMENT/CONNECTION PERMIt' OR APPLICATION TO~AL.'A$SE$SED FEES PRcVIOU~ RECEIPTS THIS RECEIPT MANUFACTOREI) STRUCTURE STATE FEE HANUFACTBRED ST~UOTURE STATE SURCHARGE HANUFACTUREQ STRUCTURE ZONIHG SURCHARGE QUANTITY AMOUNT $2~..0~ $I5.00 $226.10 $226.18 $0.00 BAL~qNCE DUE $0.00 RECEIPT RECEIVED BY: DF . . - TYPE: CHECK ,~: 0 ~* THIS IS A VALID PERMIT ~ THIS PERMIT FEE.COVERS ONE INSPECTION AND ONE REIHSPECTIOH. ALL BLOCKINg. ST~IRINSTRLLATION. PLUNBINS, MECHANICAL. AND ELECTRICAL CDMHECTIOHS ~RE REQUIRED TO SECOHPLETED UPOHREaUF..ST, FOR TNEFIRST INSPECTION. IF ~N HY OF T E ITEMS ARE INCOMPLETE, ~N ADDITiONaL INSPECTION FEE ~ILL SE REQUIRED. PERMIT IS VALID FOR SIX HONTHSOHLY,. ,:RENE~E~ FOR 6 HOHTNS UPON ~RITTEN REQUEST FOR AN EXTENS[ON~ PRIOR TO THE EXPIRATION ~ATE OF',T],IE ~ERflIT. IF CONSTRUCTION FAILS TO ' L.S-~e ' ' , ..... ' · BP'" RLHhkKS,, HF6 RE-PL~CE~EN]-ShHE FOOT: PEZN /SEPTIC CEET ~2/:[/9~ $~APPROVE~ ONLY 0MI( D~I_L~N6 AI..LOWE9 0N P~0F'E~TZ $~88~ T0 NOETHS[gE 0F S~I_.VER FAL. I..S I..MY f~{:~NAI.,[~ t':. W(~O~L, EY~ ~AkION COUNTY BUILDING OF'FIGIAL / By OFFICE COPY