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i . MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> arion <br /> Salem,OR 97305 <br /> County 503-588-5147 <br /> Site Evaluation NA FAX: 503-588-7948 <br /> OREGON <br /> 555-23-010340-EVAL <br /> www.co.marion.or.us butlding@co.marion.or.us <br /> Applicant: MILLER, RANDALL D & MILLER, RHONDA L <br /> 7836 BURTON PL SE <br /> SALEM, OR 97317 <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: TO ESTABLISH REPAIR AREA(PLA23-021) <br /> Property Address: Parcel: Owner: MILLER, RANDALL D& <br /> 7836 Burton PI Se,Salem,OR 97317 082W02C 00200 - Primary MILLER, RHONDA L <br /> Address: 7836 BURTON PL SE <br /> SALEM OR 97317 <br /> 74V41, � � 1 ;, <br /> a 9 a ; <br /> Business Name License Address Phone <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 /> I <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: 12/26/2023 1 std_BuildingApplication_pr <br />