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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Salem,OR 97305 <br /> Marion 503-588-5147 <br /> county Permit NA FAX: 503-588-7948 <br /> o aEC Q,i4 <br /> 555-23-006684-PRMT <br /> www.co.marion.or.us building@co.marian.or.us <br /> Applicant: MCGUIRE, AMBER R&GARY <br /> 1156 HORIZON RIDGE CT NE <br /> KEIZER, OR 97303 <br /> 44246, <br /> 9 ::6 <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: 4 BDRM SFD <br /> JOBS IT Ili ORMATION x <br /> Property Address: Parcel: Owner: MCGUIRE,AMBER R <br /> 695 Kare Bear Ln Ne,Salem,OR 97317 072W29AA01301 -Primary <br /> Address: 1156 HORIZON RIDGE CT <br /> NE <br /> y+,r t �yy� '` KEIZER OR 97303 <br /> -` <br /> tA� f rl+ .m'r.l S . tP �0A IN ROFFO ATION <br /> Business Name License Address Phone <br /> ° r c r e' o-+-:*t,..r. x tafe Y mrdzitiattalliW; .ram -*`74 <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 1.00 GPD $1,050.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,150.00 <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 <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 <br /> licensed unless exempted by ORS 701.010. <br /> Printed on:08/07/2023 1 std_BuildingApplicationjr <br />