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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Nano" Salem,OR 97305 <br /> County 503-588-5147 <br /> Authorization NA <br /> FAX: 503-588-7948 <br /> 0.R.E. ON <br /> 555-24-004043-AUTH <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: MORLAN, LORRIE LYNN AND ANDREW <br /> 4396 WACONDA RD NE <br /> SALEM, OR 97303 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: AUTH-REPLACE 3 BDRM MD WITH 3 BDR MD <br /> Property Address: Parcel: Owner: FREER-SELL,LORRIE LYNN <br /> 4396 Waconda Rd Ne,Salem,OR 97303 062W06D 01200-Primary <br /> Address: 4396 WACONDA RD NE <br /> SALEM OR 97303 <br /> ",. . a ACE.IGEN5I P*O*C$1 **1:*0:0 CATION a ...., ...o.... tf: _'r r a Mr i <br /> Business Name License Address Phone <br /> 1. ter„ ,: g3,',._a__ d' :aER4-wit ,..k.ram rm.TA,,...ea`.2 TTI,:.,.,.. M . ...6,.._ .',4 <br /> Fee Description Quantity Amount <br /> Authorization notice-with field visit 1.00 Ea $650.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $750.00 <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:05/23/2024 1 std_BuildingApplication pr <br />