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Permit - 1288396
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Permit - 1288396
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Entry Properties
Last modified
4/4/2011 12:00:41 PM
Creation date
9/4/2003 9:18:47 AM
Metadata
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Template:
Permits
Permit Address
9393 PORTER RD SE
Permit City
Aumsville
Permit Number
94-04515
Permit Type
Permit
Permit Doc Type
Permit Document
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PHYSICIAN'S CERTIFICATION <br /> <br /> A.~ ' .... th~. Marion County Rural Zoning Ordinan¢:e?, <br /> ....... ..... ,~ - ~da * ~,nal homesite <br />provide ......... ~:~ .-. ............. <br /> MINNET WALLACE · ~'~::~;:~'~'::~ <br />when C MRS. p. p, WALLACE <br /> <br />· ~MPORI ~,u~SV~LLE. OREGON 9732S <br /> <br /> ~ ...... <br /> <br /> ..... ~ ~ . ~ <br /> <br />be com~ ~% ~ O~?q2~,. ' ~ <br />1 20.O40L <br /> <br />This is to certify that Minnet Wallace is a patient <br /> (Please Print or Type Name of Patient) <br /> <br />of mine and is physically handicapped due to <br /> <br />chronic shoulder bursitis / trochanteric bursitis <br /> (Please Print or Type Brief Explanation of Condition) <br /> <br />It is my feeling that this physical condition requires care and attention <br />and the above-named person should be permitted to reside nearby one <br />who can give aid and comfort when the need arises. <br /> <br />?0 <br /> <br />Signature "~. <br />Name Thomas A. VAn Veen, M.D. <br /> <br /> (Print or Type) <br /> <br />Address,.,.s84~N. ~ird AYenue <br /> Stayton, OR 97383 <br />Date 10-11-94 <br /> <br /> <br />
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