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,,, ;; MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> county503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> R-EGO <br /> 555-23-004661-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: SMITH, MATTHEW L <br /> 5435 SWALLOW TAIL ST SE <br /> SALEM, OR 97306 <br /> , s xK - <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: NEW INSTALL FOR 3 BDRM SFD <br /> . .a`;£6 a! v •"°F� �Wr / ,�k308 INIi-4 ,Rl a 0 4 .E :.- y° ,vd c c .�..� <br /> .w. i„ ._,k,: he r�ad.ec�r <br /> Property Address: Parcel: Owner: SMITH, MATTHEW L <br /> 7905 Twin Fir Ln S,Salem, OR 97306 083W29D 00800-Primary <br /> Address: 5435 SWALLOW TAIL ST SE <br /> s Et SALEMOR 9 7 <br /> � a � x� 11 ,0 . owitoloLtf©RMTtQ <br /> Business Name License A ess Phone <br /> SEE PROPERTY OWNER INFORMATION Owner OWNER <br /> (Property) • <br /> �y CL� <br /> aF` <br /> _ M=PER <br /> �,s <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 1.00 GPD $1,010.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,110.00 <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:06/02/2023 1 std_BuildingApplication_pr <br />