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MARION COUNTY
<br /> Building Application 5155 Silverton Rd NE
<br /> NaYIDrG Salem,OR 97305
<br /> Authorization NA FAX: 503-588-7948
<br /> ORE G: O.N
<br /> 555-23-004182-AUTH
<br /> www.co.marion.or.us building@co.marion.or.us
<br /> Applicant: SMITH, DANIEL
<br /> 8088 ALBUS RD SE
<br /> AUMSVILLE, OR 97325
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<br /> No Code Edition Specified
<br /> Type of Work: Category of Construction:
<br /> None specified Manufactured Dwelling $0.00
<br /> Description of Work: HARDSHIP RENEWAL: MAIN 3 BDRM, HARDSHIP 3 BDRM
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<br /> Property Address: Parcel: Owner: SULLIVAN,STANLEY L&
<br /> 8088 Albus Rd Se,Aumsville,OR 97325 081W30D 01900.- Primary SULLIVAN, HELEN E
<br /> Address: 7988 ALBUS RD SE
<br /> AUMSVILLE OR 97325
<br /> � �$ LICENSE ROFESSIONAL INFOR ![ATION
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<br /> Business Name License Address Phone
<br /> ;in `'`ll ;�. PERMIT PEES ?11 f. `
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<br /> Fee Description Quantity Amount
<br /> Hardship authorization for temporary dwelling-renewal- 1.00 Ea- $150.00
<br /> no field visit
<br /> DEQ Surcharge 1.00 Automatic $100.00
<br /> Total Fees: $250.00
<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:os/17/2023 1 std_BuildingApplication pr
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