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Il*OR ~ITI' VALIDATION <br />DatlZ~ii'i ng ,V alicJ ation :1 c~/~' (''' / ~'~'~ g~ <br /> <br />c-X)MPI .ETE ALL S~CTIONS, t TIIROUGH 4 <br /> <br /> L JOB DESCRIPTION <br /> ( ) New Placement <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St, NE - Room 132 <br /> Salem, Oregon 97301 <br /> g:00ant-4;30pm Phone 555-5147 <br /> 24 HR Inspection Line $88-7904 <br /> FAX 58g-7948 <br /> <br /> MANUFACTURED DWELLING <br /> PERMIT APPLICATION <br /> <br /> Garage or Carport <br /> <br /> r FOR CI~ <br /> ,USE ONLY <br /> xo , <br /> <br />SEP 2 <br />~AfllO~ OOUNTY <br /> <br />Replacement <br />Additional Unit Add-on <br /> <br />,Type or Siding: <br /> <br />Type of Roofing: <br />( ~'Comp <br />( ) Steel <br />( ) Metal <br /> <br />( )Detached <br /> <br />No. oe ~ <br /> <br />2. LOCATION OF INSTALLATION <br />Urb~Gfowth~ou~da~? ( )Yes ( )No ~WaterSup¢Iy: ( )PdvatoWell ( )Co~unityWe[l ~City <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO iS DOING THE WORK <br /> <br />SCHEDULE <br /> <br />$,2.zs: _!~ a5 <br />$20.00 = <br />$20.00 --~.-~. ~O~ <br /> <br />RECEIPT #: <br /> <br />$60.00 <br /> <br /> <br />