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MARION COUNTY <br /> --il Building Application 5155 Silverton Rd NE <br /> NationSalem,OR 97305 <br /> Countri 503-588-5147 <br /> Inquiry NA FAX: 503-588-7948 <br /> O tt•E G:O .N.' <br /> 555-23-004622-INQY <br /> www.co.marion.or.us building@co.marion.or.us <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: ESE 4 BDRM SFD FOR PLA 23-010 <br /> t... � ,,� r 7 1`3 H<°<�s^�wx �'��r.✓x 4 er srso,✓'r '%*�" y 3^ � C� � � �'"�<�P � y ' <br /> ...y� <br /> Property Address: Parcel: Owner: BLUE LINE FARMS INC <br /> 11503 Selah Springs Rd Ne,Silverton, OR 071W05 02200-Primary <br /> 97381 Address: 4741 BRUSH CREEK RD NE <br /> N OR 97381 <br /> S ONAL S R o <br /> Business Name License Address Phone <br /> Iv <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:06/01/2023 1 std_BuildingApplication pr <br />