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f-t. MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> coutug 503-588-5147 <br /> Site Evaluation NA FAX: 503-588-7948 <br /> OREGON <br /> 555-23-007096-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: SIPPEL, DONOVAN <br /> 5756 FRUITLAND RD NE <br /> SALEM, OR 97317 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: SE: 4 BDRM SFD (LOT 7 OF 7, P/PLA 22-011) <br /> JOB SITE INFORMATION <br /> Property Address: Parcel: Owner <br /> 780 Noble Plum Way Ne, Salem, OR 97317 TEMP MC- Primary <br /> Address: <br /> LICEN D PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> Fee Description Quantity Amount <br /> Site evaluation -additional lots 1.00 Ea $750.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $850.00 <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:08/21/2023 t std_BuildingApplication pr <br />