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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marton Salem,OR 97305 <br /> County 503 588 5147 <br /> Site Evaluation NA FAX: 503-588-7948 <br /> OREGON <br /> 555-23-009739-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: AQUA RESOURCE DESIGN &CONSULTING <br /> 3439 NE SANDY BLVD. #165 <br /> PORTLAND, OR 97232 <br /> TYPE OF WORK <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Commercial $0.00 <br /> Description of Work: SE: 10 RV SPACES <br /> 308 SITE INFORMATION <br /> Property Address: Parcel: Owner: BRADFORD, ROBERT F <br /> 110 Lake St E, Detroit, OR 97342 105E01CD01300 - Primary <br /> Address: PO BOX 61 <br /> STAYTON OR 97383 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> PERMIT FEES AIM <br /> Fee Description Quantity Amount <br /> Site evaluation -Commercial facility by design capacity 1,100.00 GPD $1,030.00 <br /> gallons per day <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,130.00 <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: 11/28/2023 1 std_BuildingApplication pr <br />