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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> county Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> O R EG O jN <br /> 555-23-007516-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: MATVEEV, FENYA <br /> 18624 ARBOR GROVE RD NE <br /> WOODBURN, OR 97071 <br /> �� t�.. ��.,�-.�,.� .�`«'�.�.,n:c F� .. . .bsr��2�+�.. _ .t`�6 . .. .,.. .,. _ ._.,�' m a,,� K.�<_ .��''`.�.. ,r:•:..r ,L�s .- ..x. .-,�° ._ �v�.�.,. <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: 4BDRM SFD <br /> ng ORPtMs■ 9Nk.: ;;`s,x7t�.�: � to ay 431 <br /> p <br /> • .. ,���, r..h'a. ;1'� w' r«mow.,,... ,a„„. .n. � � ��, " . .b •.._ �.v'� .� .>. 5+�� <br /> Property Address: Parcel: Owner: MATVEEV,FENYA <br /> 18634 Arbor Grove Rd Ne,Woodburn,OR 042W26 01300-Primary <br /> 97071 Address: 18624 ARBOR GROVE RD NE <br /> WOODBURN OR 97071 <br /> Business Name License Address Phone <br /> t t ,:4.,,, �1"` : . `,.. <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 450.00 GPD $1,050.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,150.00 <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:09/06/2023 1 std_BuildingAppiication pr <br />