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12985787
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Last modified
7/29/2025 8:00:15 PM
Creation date
7/29/2025 4:58:00 PM
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Template:
Permits
Permit Address
3995 BROOKLAKE RD NE
Permit City
Salem
Permit Number
555-11-06987
Parcel Number
062W18 00200
Permit Type
Structural
Extra Information
Alternate Material(s) and/or Method(s)
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kee <br /> ad Alternate Material(s)and/or Method(s)Application <br /> Marion.County Public Works - <br /> ^i-:rron 5155 Silverton Rd NB <br /> Salem OR 97305 <br /> OREGON <br /> I one:(503)588-5147 Fax:(503)588-7948 E-mail:$ludo a co.marion.or.as <br /> .DgRcISIMIVNTAWNWO . <br /> .. . . r Eeh� . . . aligi:Littitillil;Ogi <br /> iil;Taiaiir iic;:41 11 <br /> = <br /> The iliac ke4 mna/dis der crixs hew An* .e Patoelind mcef it <br /> rdini ' at aio9- r-er Lei ri ,ub/ic rerw.s :>, A--3 4u lJins . <br /> The,WiseS ;t tut;Mt., pa,kc ket71,eovs, all i5,4 Cast serµe ✓ry <br /> Q250 Y ?i tnsi <br /> an- L.,,,A in See 0-P A- 3 60; ld, s , Adol;7%na/ <br /> portables retee nts ale if i f�Zn e v- vi i, red, clz e>ts1`c <br /> al AY[/f;]_xa eawQ,la& a,-=; Tad //''MMv s-} 4-3 4c.; this die <br /> e m epcnri- <br /> 7-e ,,,, /1Co f✓6hc anti acme is hnlitiol sewer <br /> st(� ew/c@ vai <6 I e,W aenblvijR. <br /> See c 4aco czna/yra <br /> Iiir I hereby request O to 1 material(s)and/or method(s)from that r�eppaired by code as described Wove. <br /> Signed: Date: _ n NOk to `a, <br /> OFFICE L'SL ONLY <br /> ❑Approved App]Oucd i - emu^ a-. 'd <br /> $Approved with conditions _ Getn-u,4- * o7afr tia k�~`�tla <br /> O Devied //�1 \ 1?) ///""""��. / , __ <br /> r. <br /> Signed: / ,Ik*A- b c sS2 mate: 4/25 / 20 /a <br /> Page iof2 <br /> GAFOaaS.Bln(ri1}]7amn Muses!wnadaa Aequm.am <br />
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