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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> fc7t?n11 Salem,OR 97305 <br /> County Commercial Agricultural Equine503-588-5147 <br /> g Q FAX: 503-588-7948 <br /> O R.E G: O:N <br /> 555-22-011063-AGE <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: HENRY HAZENBERG LT <br /> 5828 CHAMPOEG RD NE <br /> ST PAUL, OR 97137 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: AG EXEMPT BLDG,..249 X 100 COW BARN <br /> � 3 1 <br /> Property Address: Parcel: Owner: HENRY HAZENBERG LT <br /> 5544 Ray Bell Rd Ne,St Paul,OR 97137 042W05 01400-Primary <br /> Address: 5828 CHAMPOEG RD NE <br /> ST PAUL OR 97137 <br /> _, Via. ICl NS1 t7► PROFESS Ot�tAL IN, ORMA'LIC♦_ <br /> Business Name License Address Phone <br /> This application will expire if application acceptance cannot be achieved within 180 days. <br /> All provisions of laws and ordinances governing this type of work will be complied with <br /> whether specified herein or not. <br /> All persons or entities performing work under this application are required to be licensed <br /> unless exempted by ORS 701.010. <br /> Printed on:12/06/2022 1 std_BuildingApplication_pr <br />