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Home My WebLink AboutBuilding Miscellaneous 1979-10-31 ~ ~VLU ~ ~ SUPPLEMENT ~ ~~ Form #C74-185 TRS, TL J7--,1.~-C:;:l-tj-d.-171J () SUPPLEMENT NO. .JI:;OD~ Subd. g;/f/Y)1~1-- LotR Blk.~ APPLICATION NO. J.e-/J' 3--:79 Job Address ~Stj ~fl > d-t1/vmj ~ ~ ~;i::~ERn, ~~/~~ U~ ~J{ ___ ~ address ~/ CONTRACTOR/Applicant ~~ ?1//}-8'9?:Z plione by: C/ mail address ~ phone ?(I/)-- $'9? !L phone Des;pp~A/h1L 't (72<---;;;;:0 v BUILDING VALUATION (Revi sed) (Pri or) /~ correction /11'/ addition - Bldg. Was te Plumb. 4%' sur. Plan R. Mech. Other f8r amt, due L/ refund /'1, ()f) ,~ /-/ Cash /~eck # //~.3 Received by _4/~--, TOTAL: paid due /t?, 'FV' , Applicant's Signature~ oK.f>>..Ai;t ~ ~/ WPC By Date RSl CP&I 4fk B . a4;/' Date//J-J/-11_ ENVIRONMENTAL MANAGEMENT DEPARTMENT ADMINISTRATIVE DIVISION / 125 EAST 8TH AVENUE / EUGENE, OREGON 97401 / (503)687-4394 OR 1-800-452-6379