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�,.. . . <br /> ". MARION COUNTY <br /> Building Application 5155 Silverton Rd NE , <br /> MarionSalem,OR 97305 <br /> county 503-588-5147 <br /> Site Evaluation NA <br /> FAX: 503-588-7948 <br /> O.R.E`.G:O.N <br /> 555-23-005832-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: FOBERT, PAUL W&FOBERT, SUSAN <br /> 18871 FOBERT RD NE <br /> HUBBARD, OR 97032 <br /> `f7' 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 4 BDRM SFD <br /> 1104, s ]OB SITE INFORMATION s f;, 41 y ,y�.� �� t�� *> <br /> _ ,._ "�r. •t- � ... ._ � ...� a ..>. ,._ _ :'�`."�: aiP`�aea ...« <br /> Property Address: Parcel: Owner: FOBERT, PAUL W&FOBERT, <br /> 19290 Fobert Rd, Hubbard, OR 97032 041W26 01200-Primary SUSAN <br /> Address: 18871 FOBERT RD NE <br /> HUBBARD OR 97032 <br /> . . is !VegP b 10k LICENSED PROFESSIONAL INFORMATION t „* <br /> Business Name License Address Phone <br /> '�`'''2x" ,�;"r 4, ,ea :cs+ ?� � : �rp.m s�` r9y� x vt ;t z n �i'.n �.yS v �... <br /> a ' _ �` � U se �� x ti BERNfItiPtgS g a� r �e i <br /> r..,.< .a.a�,�. ,t ,.i�'.a."<. _ �:«k. a r4;�F,_.o'-'�"n�F %.�n.��.�., . .,M:a��ax..n.°�,kev�4,�., ..F,T,e,.., � ?.`6,,,., s �.� ,�'� � '� ;�.,. ' <br /> Fee Description Quantity Amount <br /> Site evaluation-Single family dwelling 1.00 Ea $810.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $910.00 <br /> Note:This may not include a!!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:07/10/2023 1 std_BuildingApplication_pr <br />