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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Natio 1 Salem,OR 97305 <br /> county Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> O R.E G: O.N <br /> 555-22-002332-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Lone Pine Corner Septics Inc. <br /> 8778 Cascade Hiahway. NE <br /> Silver-ton, OR 97381 <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: 5 BDRM SFD <br /> 70B SITE TNFORMATION <br /> Property Address: Parcel: Owner: DOUGHERTY, MATTHEW G <br /> 6138 Cascade Hwy Ne,Silverton,OR 97381 061W36B 00200-Primary <br /> Address: 6138 CASCADE HWY NE <br /> SILVERTON OR 97381 <br /> Business Name License Address Phone <br /> LONE PINE CORNER SEPTICS INC. Installer 37003 8778 CASCADE HIGHWAY,NE SILVERTON (50-3)-873- <br /> License OR 97381 <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 525.00 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 /> 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:03/17/2022 1 std_BuildingApplication_pr <br />