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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> •NationSalem,OR 97305 <br /> County 503-588-5147 <br /> Inquiry NA FAX: 503-588-7948 <br /> O.R•E`G: O.N <br /> 555-23-004621-INQY <br /> www.co.marion.or.us building@co.marion.or.us <br /> a 1 a ,�� TYPO*WORK a N <br /> ,'�.. „dr.i��.,h„r?.�,.� 4��,3 � s"<.e rx,m„�,. .„,�r,. .,,. ,,•, ..: ..,s.�3sa,. . sfai:,.. <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 FOR PLA 23-010 <br /> Property Address: Parcel: Owner: BLUE LINE FARMS INC <br /> 11513 Selah Springs Rd Ne,Silverton,OR 071W05 02200-Primary <br /> 97381 Address: 4741 BRUSH CREEK RD NE <br /> SILVERTON OR 97381 <br /> .r 1 '4.c; a ; �,�}.N K � r,r° f ,.I ICI:l�t51_I? 1 R0� 3�OI AL IN FpRMAT1O1 .... '•., „„> .,A .•6,,. -.� .f441:!!5, `.... <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:0e/01/2023 1 std_BuildingApplication pr <br />