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• <br /> MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> cation Salem,OR 97305 <br /> County Inquiry NA 503-588-5147 <br /> I <br /> Q ry FAX: 503-588-7948 , <br /> 0 R E'.G;O N. <br /> 555-24-006535-INQY <br /> www.co.marion.or.us building@co.marion.or.us <br /> • <br /> RP, *IA <br /> "„ �'�°s q ,�' .�,tea , � �',� -; ._. � „ �•. ..�... ,�., „...'�. '� <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: ESE: 2 BDRM SFD(FUTURE PART LOT 1 OF 5) <br /> 7 tax f <br /> may* <br /> 9•. y ,° z, ,asB aSt „mci :57444 3,,,4. a as- <br /> Property Address: Parcel: Owner: HATHAWAY,AMBER MARIE <br /> 5133 Center St Ne,Salem,OR 97317 072W29AB01500-Primary JOHNSON <br /> Address: PO BOX 6140 <br /> SALEM OR 97304 <br /> LICENSEDwPR OFES ONAL IN RMA.TI N <br /> Business Name License Address Phone <br /> @ ."L.,,,:v;bm:-!sir 4, ffi��<r<...e,�7"'`'��'�1�'s'�F,. <br /> Fee Description Quantity- Amount <br /> Existing system evaluation report 1.00 Ea $650.00 <br /> DEQ Surcharge 1.00 Automatic $117.00 <br /> Total Fees: $767.00 <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:08/16/2024 1 std_BuildingApplicationjr <br />