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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> county 503-588-5147 <br /> Authorization NA FAX: 503-588-7948 <br /> ORE G; ON' <br /> 555-23-007836-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: LATIMER, PAMELA <br /> 5828 SHAW HWY SE <br /> AUMSVILLE, OR 97325 �� <br /> 4 ..,,. rqy�`'�->ak+ -E<x'�dri '..h ,,,t. x' ..�i•. :. a-. VC4I4, h. 'p.., f, #:F°w' ,.�'„ .�..,' [-s-'t , ., _ .. :.... <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified 2 BDRM TINY HOUSE ON WHEELS $0.00 <br /> Description of Work: AUTH FOR 2 BDRM HARDSHIP-EXISTING HOUSE IS 4 BDRM SFD <br /> fitxireitkargai, k.s O S ORI�IATI r � ffi° ._ '� <br /> fie, ...-..,.z..,,_ ,..,.. � h'sSF ,.IYa..; �..,5». �§,. m, ,x<,i� ..ev�, .w d6...,... <br /> Property Address: Parcel: Owner: LATIMER, PAMELA <br /> 5828 Shaw Hwy Se,Aumsville,OR 97325 081W18C 03900-Primary <br /> Address: 5828 SHAW HWY SE <br /> AUMSVILLE OR 97325 <br /> iter` LICENSED PROF ON L TNI`f A" a . ,. <br /> Business Name License Address Phone <br /> tytitre <br /> . IZAESIni P E MXT FEG M 'S*.' 4s} J cv, <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $650.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $750.00 <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 an:09/18/zaz3 i std_BuildingApplication pr <br />