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MARION COUNTY <br /> _ -- Building Application 5155 Silverton Rd NE <br /> 17at7Dtt Salem,OR 97305 <br /> County 503-588-5147 <br /> Site Evaluation NA FAX: 503-588-7948 <br /> O R.E' G.O,N <br /> 555-22-006542-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: GOBAT, STEVE <br /> 7235 SARAH LN S <br /> SALEM, OR 97306 <br /> "> :. s � �.,,-•S� sd-., k` at .b ar /� 1t1�� '$ ': 3' �' � s ��.�" '�,�,� �:� 2`r Say.'a � �, <br /> >.r,.��%�-, ��.�-. � �""'_.. �-.��.,,�..�,�,£x .,'?;:.�,�'��; `��.�.'�vl3,i�.v�1�1[��•,..� � ,�_?� =; nh,�,r_-�,.....:�.,_ �'.,• ::��x�•,v�H�,..,.�<..a <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 3 BDRM SFD (COMBINING 5 LOTS INTO 1) <br /> Property Address: Parcel: Owner: EDWARD W KRAMER RLT <br /> 1785 Eider St Se,Jefferson,OR 97352 103W02BA02200- Primary 50% <br /> Address: 3155 TALBOT RD S <br /> JEFFERSON OR 97352 <br /> ?daCENS .b PROFESS,SIONAL IN ,,;;- A O C ^: >•., <br /> Business Name License Address Phone <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:07/22/2022 1 std_BuildingApplication pr <br />