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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> County 503-588-5147 <br /> Site Evaluation NA <br /> FAX: 503-588-7948 <br /> OR+E ,O O.N✓ <br /> 555-23-005115-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: MATVEEV,ANTONI <br /> 18624 ARBOR GROVE RD NE <br /> WOODBURN, OR 97071 <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 FOR FUTURE 4BDRM SFD <br /> ZniV #- M d 9A , 'i��S Y <br /> ���'�` ���,.. � Asa d � 308 S1TEINFORMATION <br /> Property Address: Parcel: Owner: MATVEEV,FENYA <br /> 18634 Arbor Grove Rd Ne,Woodburn,OR 042W26 01300-Primary <br /> 97071 Address: 18624 ARBOR GROVE RD NE <br /> WOODBURN OR 97071 <br /> Business Name License Address Phone <br /> s <br /> e - ..1, *, a . m,PERMI�T FEES T 4 � �., if <br /> ., .�,,.�, ,., e _: .. .,.< ':. .,.,.. . . .. . .... .. . ... � Ir..<.. .. � a.A �x F` <br /> Fee Description Quantity Amount <br /> Site evaluation-Single family dwelling 9 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:06/15/2023 i std_BuildingApplication pr <br />