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- MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> County 503-588-5147 <br /> Site Evaluation NA FAX: 503-588-7948 <br /> O REGOly <br /> ............... . . .._ <br /> 555-23-008464-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: CONNOR LT&CONNOR, SEAN R THE <br /> PO BOX 5 <br /> ST PAUL, OR 97137 <br /> " V � ..r1 1 1*F74 rWa. an I g zi -r M <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 FOR FUTURE 3BDRM SFD(PLA 23-032) <br /> T <br /> Property Address: Parcel: Owner: CONNOR LT&CONNOR, <br /> 20703 Riverside Dr Ne,St Paul,OR 97137 043W13D 00500- Primary SEAN RTRE <br /> Address: PO BOX 5 <br /> 97137 <br /> :,tea' ° cu4�a� ^��,.�1[�� L��!v ✓e x 9 ���— ,� � �� <br /> > T� F NAil.scIN FO a u - s'�' <br /> Business Name License Address Phone <br /> PACIFIC NORTHWEST EXCAVATING, Installer 38846 PO BOX 61 WILSONVILLE OR 97070 503-329-5007 <br /> aliffLLC License <br /> f • f vf ,�F x�y 11,4"agftirliei?:.. ;: eit* <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 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:10/06/2023 1 std_BuildingApplication jsr <br />