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I 1.. <br /> MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> County 503-588-5147 <br /> Site Evaluation NA FAX: 503-588-7948 <br /> O:R•E.GO.N' <br /> 555-23-005327-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: HARDIN, BRIAN W&HARDIN, SUSAN A <br /> 5770 HOMESTEAD WY SE <br /> AUMSVILLE, OR 97325 <br /> s O x �� a a <br /> . .7� , �� a��, 4�°, � a:. ����a,��, � ` -,s 'f•YP �WI�RK�� � ...�.ua .� �� �.� �t� z .s�� �., ,� �.,,� <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: SE: FUTURE 3BDRM SFD(LOT 2 OF 2,PLA 22-044) <br /> Property Address: Parcel: Owner: HARDIN, BRIAN W& <br /> 5770 Homestead Way Se,Aumsville,OR 97325 081W18 01100-Primary HARDIN, SUSAN A <br /> Address: 5770 HOMESTEAD WY SE <br /> AUMSVILLE OR 97325 <br /> "h. ,�:; ;I : ; t..•, 5, ,. .. S ,F a s r q q�* t a n <br /> �„ ,�� �, LICENSED PROF�5SIE'�NI�IL"INFt}RL�!tA't'ION�., � ..A .� �,�.y ,. ���� �� � t �,, <br /> Business Name Licensee c�Address Phone <br /> ^�W�°$:A t t � f d+-,Y� S N„w�wS 0. <br /> K.,:.R''ERM +�4` EGa'T "AP'. �2�Y 6 YP'd i <br /> Fee Description Quantity Amount <br /> Site evaluation-Single family dwelling 1.00 Ea $725.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $825.00 <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 on:06/21/2023 1 std_BuildingApplication pr <br />