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.;�nfi N;4 MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> aiZ:712 Salem,OR 97305 <br /> lifCountIy Inquiry NA503-588-5147 <br /> FAX: 503-588-7948 <br /> O.R-EC:ON <br /> 555-23-002166-INQY <br /> www.co.marion.or.us building@co.marion.or.us <br /> TYP,E,+D WORK, <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: ESE FOR PARTITION #22-035 <br /> Property Address: Parcel: Owner: JOANNE ANDERSON LLC <br /> 18906 Butteville Rd Ne,Aurora,OR 97002 041W30 00700-Primary <br /> Address: 9494 BROADACRES RD NE <br /> H A DOR9 <br /> LICENSED PROFESSIONAL;INFORMATION <br /> Business Name License Address Phone <br /> Fee Description Quantity Amount <br /> Existing system evaluation report 1.00 Ea $565.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $665.00 <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:03/13/2023 1 std_BuildingApplication_pr <br />