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MARION COUNTY <br /> BI. JILD~NG INSPkC lION <br />Senator Building · 220 High Stre¢~ NE · Second Floor · Salem,, ©rego~ 07301-3670 <br />OffieeHoms 800-430 Phone 588-5147 24 Hour Code-A-Phone 588-7904 <br /> <br />:NSPECTION REQUEST <br /> <br />Receffved <br /> DaTe <br /> Tffme <br /> <br />9031~78 Setbacks FR: <br />RESIDENTIAL LS: <br /> <br /> 0wrier: HOLOUBEK,ROSERT <br />eob eddr~s: 200 SAN%lAM AVE -- <br /> DETROrT OR 97342 <br /> <br />Phone: <br /> <br />AUTHORIZATION NOTICE - <br />Pepmi~ p~u~rememCe: ALJT~f - FIELD CHECK <br /> <br />Number <br /> i <br /> <br /> _ ]NSPECTtON REPORT <br />I~spec~ed 8~'; ............... <br /> <br /> <br />