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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marian Salem,OR 97305 <br /> county Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-22-004283-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: ANDERSON, PAUL <br /> 105 WELCH ST <br /> SILVERTON, OR 97381 <br /> TY <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: NEW INSTALL: FUTURE 3 BDRM SFD <br /> Property Address: Parcel: Owner: ANDERSON,PAUL <br /> 11484 Hazelgreen Rd Ne,Silverton,OR 97381 061W32 00901-Primary <br /> Address: 105 WELCH ST <br /> SILVERTON OR 97381 <br /> LICENSED PROFESSQNAL',INFORMATION �. ._Q " <br /> � Y <br /> yg <br /> Business Name License Address Phone <br /> b, .6-;�" � ,�.-a u.. vex a;'�.,';.a„;,.,ai'1., PERMIT FEES 3 .✓:'&" � ,r ^" '�-_" sE .,.n,� <br /> �.. .......mr,. ,�._. <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 1.00 GPD $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 /> • <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:05/12/2022 1 std_BuildingApplication pr <br />