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MARION COUNTY BUILDING INSPECTION <br /> COMMUNI'FY DEVELOPMENT CENTER <br /> <br /> 285 Church Street NE · Room 132 · Salem, Oregon 97301-3670 <br />Office Hours: 8:00-4:30 · Phone: (503) 588-5147 ° 24-HR Inspection Line: (503) 373-4427 <br /> <br /> ~NUFACTURED DgELLING APPLICATION <br />D~TE/TIHE : ~7/B8/96 I~=B~ ACTIVITY NO = 96-B5~35 <br />TYPE = ge~ Manufactured D~eZI~ng STATUS = APPLIED <br />OCCUPN4CY = R-3 ~PPLIED = e7/~8/1996 <br /> TO EXPIRE = ~1/B4/1997 <br /> PAgE 1 <br /> <br />WORK DESC : MFG 3BEDR REPL: 2BEDE <br />SITE ADDRESS : <br /> <br />CROSS STREET <br /> <br />PARCEL NUMBER <br />PARCEL SIZE <br /> <br />OWNER NAME <br /> <br />APPLICANT <br /> NAME <br /> ADDRESS <br /> <br /> PHONE <br /> <br />CONTRACTOR/ <br /> AGENT <br /> PHONE <br /> <br />INSTALLER <br />PHONE <br /> <br />UNIT SQFT <br /> <br /> Units <br /> 1 <br /> 1 <br /> 1 <br /> 1 <br /> <br />9205 BATES RD SE AM <br /> <br />: WEST STAYTON <br /> <br />: 58295-888 <br />: 3.8AC <br /> <br />: dURICICH, dEAN E <br /> <br />: GIGOUX-JURICICH~TAMMY <br />: 9285 BATES RD <br /> AUMSVILLE, OR <br /> <br />97325 <br /> <br />GIGOUX-JURICICH~TAMMY <br /> <br />Description <br /> Ma"huYactu~ed d~eiiing fde <br /> State surcharge <br /> State administrative fee <br /> Zone surcharge <br /> <br />CITY: MARION-COUNTY <br /> <br />OCCB: <br /> <br />MD LICENSE: <br /> <br />Fee <br /> 245~00 <br /> <br />12.25 <br />28.88 <br />28.88 <br /> <br /> Assessed fees : 297.25 <br /> Adjust~)ents : .88 <br /> Total fees : 297.25 <br />PAYEE: GIGQUX-JURICICH, TAMMY Total pa%Ments: 297.25 <br /> Balance oue : .88 <br /> <br />THIS IS NOT A PERNIT. THIS APPLICATION NUST GO THROUGH A SIHULTANEOUS REVIEM <br />PROCESS WHERE ZONING, SEPTIC (IF APPLICABLE) AND SITE PLAN IS CHECKED PRIOR TO <br />THE ISSUANCE OF A PERHIT. IT IS THE RE~IBILITY DF THE APPLICANT TO ASSURE <br />THAT ALL NECESSARY INFORHATION T~IDED~ AS SOQH AS 41LL REOUIREHENTS OF THE <br />REVIEW HAVE BEEN HETj~.~[OU'WI_J.L~ HOTIF].L~T Y~IT HAS BEEN ISSUED. <br /> <br />DONALD E WOODLEY, MARION COUNTY-BUlL. DING OFFICIAL / BY CLYNCH <br /> <br />SITE / ~GB: FD <br />MAP: 51R ZONE: AR <br /> <br />REQD SETBACKS:Front: <br />PLAN REVIEW : <br /> <br /> .FOR OFFICE USE ONLY <br /> <br /> PROPERTY LOCATOR: 882W36A 81888 <br /> <br />Left: 9~9 Right: ~?~ Rear: ?~ Special: 999 <br /> <br />DATE: ZONING REVIEW: DATE: <br /> <br /> <br />