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MARION COUNI'Y 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) 588-7904 <br /> <br />DATE/TTHE <br /> <br /> *. HA~.JFACTURED O#ELL[Hg APPI.TCATIOH <br />.= g2/]5/g& 1&=21 ACTIVITY NO : 9&-~787 <br /> : ~le.~ Manitfactured Dwellin§ STATUS : APPLIED <br /> =K-a APPLIED : B2/15/199& <br /> TO EXPIRE <br /> PAGE <br /> <br />WORK ~PF~C <br /> <br />SITE Ai)'ORESS <br /> <br />: MFg HOHF - 9P t70 - WZflPEMFRF MFAPOW9 <br /> B~] A~RFY L.H SE AM <br /> <br />gl'FY: AUflSVILLE <br /> <br />CROSS STREET : WINQEMERE ST <br />PARCEL NUMBER : .,6299-00~ <br /> <br /> PARCEL SIZE : 73~8.8 SF <br />OWNER NAME : SANTIAM HOMFS <br /> <br />APP~.ICANT <br /> NAME' ROFHM, IOHN <br /> AOORESS ~ 17277 ~ FERNWO0~ <br /> MOtAlt. A~ OR <br /> <br /> PHONF <br /> <br />CONTRACTOR/ <br /> A~FNT <br /> PHONE <br /> <br />~N~TA[IER <br />PIt[~NE <br /> <br />I~N~T ~ FT <br /> <br /> IJnits <br /> <br /> 1 <br /> <br />.- 827-2~68 <br /> <br />: RIIFHM, .IOHH <br /> <br />: 15]? <br /> <br />97~8 <br /> <br />Oescription <br /> MantLfaC~'red 'dwe~]'~'~g"fee <br /> State s~ir~harqe <br /> State administrative fee <br /> <br />occB: <br /> <br />MD LICENSE: <br /> <br />Fee <br /> <br />24~,00 <br /> 12.25 <br /> 28,88 <br /> <br /> Assessed fees : 277.25 <br /> Adjustments : .0~ <br /> Total fees : 277.25 <br /> Total payments: .00 <br />· PAYEE: ROENM..JOHN Balance due :. 277.25 <br /> <br /> THIS IS HOT A PE~IT. THIS AP~.ICATIOH HUST ~0 THROUGH A SIHULTPJ~EOUS REVIEW <br /> <br />PROCESS ~R4E]~EZOHIH~, SEPTIC (IF APPLICABLE) AND SITE PL.~H IS CHECKED PRIOR TO <br />THE ISSUANCE OF A PERHIT. IT [S THE RESPONSIBILITY OF THE APPLICANT TO ASSURE <br />THAT. ALL NECESSARY IHFORHATIDH IS PROVIDED. AS SOOH At~ ALL REOUIREHEHTS OF THE <br /> <br />.... gE'VI~ H~VE I~IEENi~IET, YOU gilL BE NOTIFIED TI4~T YOUR PERHIT HAS BEEll ISSUED. <br /> S'~GHA'FI.IRF OF' APPLICANT: <br /> <br /> O~NAIP F WOOPlEY~ HARMON COUNTY ~ll~[..~N~ OFFiCiAL / BY PHUNRO <br /> <br /> *FOR OFFICE USE ONLY <br /> <br />NAP: 5] ZONE: I PROPFRTY IOCATOR: 081W~0 02308 <br /> <br />REQD SETBACKS:Front: Left: Right: Rear: Special: <br />PLAN RFVTFW : ~ATE: ZONTNg. REVIEW: DATE: <br /> <br />IIIIIII Bill BillIIIIIIIII <br /> <br /> <br />