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FOR CITY VALIDATION <br /> <br />Zoning Validation: ~ <br />Date: <br /> <br />COMPLETE ALL SECTIONS, 1 THROUGH 4 <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 285 Church St. NE - Room 132 <br /> Salem, Oregon 97301 <br /> 8:00am-4:30pm Phone 588-5147 <br /> 24 HR Inspection Line 588-7904 <br /> FAX 588-7948 <br /> <br /> MANUFACTURED DWELLING <br /> PERMIT APPLICATION <br /> <br />FOR <br /> <br />Rear: /.fi'- .' <br />R~t si,~: <br /> <br />( ) Replacement (~'~Attached <br />( ) Additional Unit Add-on ( ) Detached <br />Dealers ~t~ ~,~y~.g_ Year of ,_ No. of Length <br />Name: /-2L~n.~l' ManufactarerJ? 7 Sections '~ <br />Type o Siding: <br />( ~o~S ~d Type of Roofing: Square Footage: <br /> ( ~mp <br />( ) Metal ( ) Ste~l Pit Set: Ener~: <br />( )Vinyl ( )Mel~l <br /> <br />2. LOCATION OF INSTALLATION <br /> <br />Mobil~ Home Park Name: <br /> <br />Property Owner: <br /> <br />Section: .~0 Township: ~ <br />Lot Width:$ t Lot Depth: 9qt <br />Urban Growth Boundary? ( ~'~Yes ( ) No <br /> <br />3. CONTRACTOR INFORMATION -- PLEASE INDICATE WHO IS DOING THE WORK <br /> <br />4. FEE SCHEDULE <br /> <br />77~-t/f <br /> <br />B. Additional Inspection/ <br /> (beyond third inspection) <br /> Reinspecfion Fee <br /> <br />$60.C0 = <br /> <br />I hereby ce~fy ~at the above information is correct. Permits are non-transferrable and expire if work is not started within 180 days of issuance <br />or if work is suspended for 180 days, ' ~.'-I, ..~-;tng--~ -7 7 ~ ,~ <br />NAME OF APPLICANT (please print): PHONE: <br /> <br />SIGNATURE OF APPLICANT: __DATE: ~ <br /> <br />MC 1544 Rev 3/95 <br /> <br /> <br />