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12985313
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Last modified
7/29/2025 8:00:14 PM
Creation date
7/29/2025 3:44:59 PM
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Template:
Permits
Permit Address
750 GRICE LP S
Permit City
Jefferson
Permit Number
555-13-02501
Parcel Number
103W12CC12300
Permit Type
Revision
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Umpqua Testing Service �i <br /> Myrtle Creek, Oregon Project: C.! nu erg-lm€ Ta4,,ye /, <br /> th. POLL re.a lto P(dce. lcfrij <br /> i oP 4 Bimi Cei3 ki, sr <br /> i <br /> L s . <br /> :V scc.i-- <br /> ft - <br /> ..� <br /> kr <br /> 1 <br /> �''5130�350 % ` <br /> 400 L <br /> ''n9 450 <br /> -Fr. 500 <br /> 7' 550 <br /> J nm nmo 500 <br /> �wr 1oggIXEI Nw <br /> / /5 Pg. 2 of 8 <br /> 11 <br /> Signature: ,f/-U Date: / "a 9 —/� <br />
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