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MARION COUNTY BUILDING INSPECTION <br />COMMUNIT~ DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE * Room 132 · Salem, Oregon 97301-3670 <br />office Hours: 6;00-4:~4~ * Phone: (503) 588-5147 · 24-HR inspection Line: (503) 588-7904 <br /> <br /> flANUFACTURED DWELLIN~ APPI.~CATION <br /> 9ATE/T~HE : ~B/28/75 12:l& STATUS = APPLIED <br /> PERHIT NO : ?5-15515 APPLIED = 08/28/1975 <br /> <br />~:'=C£:A$S = TO EXPIRE : e2/24/197~ <br /> <br /> ~ORK DESC : NMF~ 3 <br /> ~2813 ARHDT RI) HE 6R <br /> <br />STREET : KL. UPEN(;ER RD NE <br /> <br /> NUMBER : 4009,5-000 <br /> <br />APPLICAHT <br /> NAME <br /> ADDRESS <br /> <br /> PHONE <br /> <br />~ONI'EACTOR <br />PHONE <br /> <br />INSTALLER <br />PHQNE <br /> <br />UI,I[ T ,~Q <br /> <br /> 97~01 <br /> <br /> OCCB: <br />HDI LIC: <br /> <br />tJn:[~s Descr ~,~:~ioy~ ~ Fee <br /> <br /> 1 State surcharge 12., 25 <br /> 1 State ad~d,~is~rat&ve fee 20.0~ <br /> 1 Zofm sure:barge ,_g,. ~B <br /> <br /> Assessed fees : <br /> Ad just~tents .- .00 <br /> Total fees : 2~7, 25 <br /> Toi;,~l pay~en'[s: 2?7.25 <br /> ............................... ~ c~,~,~ .................... <br /> <br /> OOHAL. D E. WOOOL..BY,: MARION COUHTY BUI,..glNG OFFICIAL/BY <br /> <br /> MAP: ZONE: EfLI PROPERTY LOgATOR~ ~glW34 <br /> <br />I,~EQUI"['.O 3;'TBAC(S: Fr:m'":~ Lef'[::~ Right~ Rear~ Speci4~,l:999 <br /> <br /> <br />