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MARION COUNTY <br /> --= Building Application 5155 Silverton Rd NE <br /> NadalSalem,OR 97305 <br /> COunc 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> O R:E G: O,N <br /> 555-22-011426-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: ROSENAU, LARRY <br /> 9435 ROSELAND WAY SE <br /> TURNER, OR 97392 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: NEW INSTALL FOR 3 BDRM SFD <br /> t <30,8 SITEIN�t)RM4TI0[ , <br /> Property Address: Parcel: Owner: ROSENAU,LARRY <br /> 9435 Roseland Way Se,Turner,OR 97392 092W06B 00903- Primary <br /> Address: 9435 ROSELAND WAY SE <br /> TURNER OR 97392 <br /> �� a ..:LICENSED PROFESSIONAL INFORM T[ION ... ,. 3;�.� ;. r <br /> Business Name License Address Phone <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 1.00 GPD $1,010.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,110.00 <br /> Note:This may not include all the fees required for this project. <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 an:12/15/2022 1 std_BuildingApplication_pr <br />