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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: ";88-5147 8:00 - 4:30 <br />24 HOUR CODE-A-PHONE: 5,88-7904 <br /> <br />lamaregisteredbuilderOl~( )theauthorizedrepresent¢tive <br />of a registered builder, <br /> <br /> §ilO§ Ab~S~; obcb~^NC¥: <br /> <br /> AU~tSVILL. K OR 97525 , ~.dH,~VIl,.Lk, NO <br />~ STRUCTURE 3 <br /> <br /> VALUATZON~ <br /> <br />TYPE: MANUFACTURE:D STRUCTURE PERMIT OR APPL![iBATIOH NO: <br /> <br />CA Mr='~¥(LJ_ HOMES <br />791:1. SQU'[~REL HiLL RD <br />,:~AI... LH,~ <br />PHONE~ <br /> <br />MANUFACTURE]) S'i'RUC'FURE F'LACE~EN(/CQNNECTION <br />~'~ANU;::ACTUf~ED S'~ f~[JC'TLIRE STA'T E <br />MANUFAC¢'URED STi~UC'FURE STATE SURCHARt;E <br /> TOTAL ASSESSED FEES <br /> PREVIOUS RECEIPTS <br /> t'H~S RECEIr"T <br /> ; BALANCD 9UE <br /> <br />905802~ <br /> <br />QUANTITy AMOUNT <br /> :~9,, <br /> <br /> J~f, rJ,,I..,, bal,,.,x.o.I Awrt:(ng / Sa)'r[:iaM Hoi,~es ' " <br /> <br /> ,,, i "- · ..................................................... ~:,L,,~ ........ <br /> ~' TH~ZS NOT A PERMIT THiS A~pLICA~ION MUST GO THROUGH A REVIEW PROCESS WHffRE THE <br /> E O ~ C TE I S IBILITY OF THE APPLICANT TO ASSURE <br /> <br />~ ,h~k.[,lt:, (-,,,,,1 :(.A. <br /> <br /> ,,, z/" PAT[ <br /> <br /> RI. <br /> ,,, ¢,d,. M~:;~ LA OJ, :-'~[BT'"'::-MILL CREEK'~EBTATES <br /> <br />Po.~ ~ uc ~s-~ aez. 4/~o OF FICE COPY <br /> <br /> <br />