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11189686
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11189686
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Last modified
10/17/2022 3:37:08 PM
Creation date
8/11/2022 11:14:05 AM
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Template:
Permits
Permit Address
5515 SERENITY DR SE
Permit City
Salem
Permit Number
555-22-005828-AUTH
Parcel Number
083W13DB00400
Permit Type
Authorization
Permit Doc Type
Permit Document
Status
Ready to Film
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SIGNATURES <br /> CITY OF `ALEt'tl PLANNING OFFICIAL: <br /> • (Print Name) PLANNING' Oi IAL(Signature) <br /> 555 LaSestet sr-sF r.oesA 3os <br /> 5(zo/ZozL 5AielIOFg. 97301 So3-silo-z3c <br /> .11 <br /> DATE ADDRESS TELEPHONE# <br /> *COUNTY PLANNING OFFICIAL <br /> (Print Name) PLANNING OFFICIAL(Signature) <br /> DATE ADDRESS . TELEPHONE# <br /> *If necessary,depending upon city/county agreement on jurisdiction outside city limits but within UGB. <br /> G:\FORMSISEPTICIS-39 LUCS.DOCX Rev:8/10,04/12,03/18 <br />
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