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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 />I am a registered builder OR the authorized representative <br />The work will be performed by a registered builder. <br /> <br />this document, <br /> <br />AUMSVZLLE OR 97325 AUMSVILLE ~o <br /> <br />11~72 H~LL C~EEK RD <br />~UMSV~LLE OR ~7325 ~ SITE NU~BER: 94-~3774 <br />HONE. 7&9-7744 ~ V~LUATZ8N~ <br /> <br />TYPE= HANUFACTURED STRUCTURE PERflIT OR APPLir_.ATIDN ND: <br />CONTRACTOR, NO. 98~40 <br /> Capitol AwDing / Sa~iam Homes <br />~I8 Valleywood Dr SE <br />Salem, 97~86 <br />PHONE: ~63-1711 <br /> <br />ITEM <br />MANUFACTURED STRUCTURE PLACEMENT/CONNECTION <br />MANU~ACTUREQ STRUCTURE STATE FEE <br />HAHUFACTUREB STRUCTURE STATE SURCHARGE <br /> <br /> TOTAL ASSESSEDPEES <br /> PREVIOOSRECEIPTS <br /> THIS RECEIPT <br /> :B~L~NC£ i DUE <br /> <br />QUANTITY AMOUNT <br /> <br /> $28.00 <br /> $~,,10 <br /> <br />$211.10 <br /> $0.00 <br />$211.10 <br /> <br />$0.00 <br /> <br />PAYEE: Capitol Awning / Sant;i. amHomes: ' INVOICE 61024 <br />RECEIVED BY: BF <br />· THiS IS HUT A PERHIT. THIS~A~PLzcATION:HuSTGOTHROUGH,AREVIE# PROCESS ~HERE THE <br />FSLLO~IHGHUST 8E COHPLETE~.,IT IS, THE:RESPONS~SILiTYOFTNE APPLICAHT TO ASSURE <br />THAT All RECESSARY INFORHATIONHAS, BEENPROVI~ED:~ <br /> <br />SEPTIC'- <br /> <br />CITY JURISDICTION: BY DATE <br />REMARKS: MS,) CARPORT <br /> <br />SETBACKS: FR 10 <br /> LS-15 <br /> RS-:15 <br /> RR-I§ <br /> sPZ ..... <br /> <br />O!'FiC: COPY <br /> <br /> <br />