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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Ma110>? Salem,OR 97305 <br /> • Gaunt 503-588-5147 <br /> Authorization NA FAX: 503-588-7948 <br /> OR.E'G: O;N <br /> 555-22-002828-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: LOOMIS-PRICE, LAWRENCE D <br /> 1258 HILLENDALE DR. SE <br /> SALEM,OR 97302 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: AUTH-REPLACE 3 BDRM W/4 BDRM SFD <br /> Property Address: Parcel: Owner: LOOMIS-PRICE, LAWRENCE <br /> 35404 Francis St Se, Lyons,OR 97358 084E32BD01600-Primary D <br /> Address: 46 FIRETHORN PL <br /> �R �rON NF /.� THE WOODLANDS TX 77382 <br /> 0:t4 ORMATION •',k <br /> Business Name License Address Phone <br /> SEE PROPERTY OWNER INFORMATION Owner OWNER <br /> _(Property) <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $450.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $550.00 <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:04/04/2022 r1 std_BuildingApplication pr <br />