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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> /c?YIOYl Salem,OR 97305 <br /> county 503-588-5147 <br /> Site Evaluation NA FAX: 503-588-7948 <br /> OREGON <br /> 555-23-007092-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 /> 7f2g c. a�a ,,em <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 2 OF 7, P/PLA 22-011) <br /> Property Address: Parcel: Owner: SIPPEL, DONOVAN <br /> 740 Noble Plum Way Ne, Salem,OR 97317 TEMP MC- Primary <br /> Address: 5756 FRUITLAND RD NE <br /> SALEM OR 97317 <br /> LICENSED PROFESSIONAL INFORMATIO„ <br /> Business Name License Address Phone <br /> PERMIT FEES <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 1 std_BuildingApplication pr <br />