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MARION COUNTY <br /> -==-= - Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> county Permit NA 503-588-5147. <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-22-002987-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Rock Hill Construction, LLC <br /> 30387 Rancho Rd <br /> Lebanon, OR 97355 <br /> _,3 M TYPE OF WORK <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: 4 BDRM SFD <br /> OE SITE"INFORMATIO*41.. .. 11LI. ? <br /> Property Address: Parcel: Owner: MCGEHEE,STANLEY L. <br /> 14962 Laurel Ln Se,Jefferson,OR 97352 093W35CD00900-Primary <br /> Address: 37308 AGATE DR <br /> LEBANON OR 97355 <br /> " LICENS D PROFESSIO!tAL.INFOI MA'CICON. .,._ <br /> Business Name License Address Phone <br /> ROCK HILL CONSTRUCTION,LLC Installer 39009 30387 RANCHO RD LEBANON OR 97355 (54-1)-619- <br /> License <br /> PERMIT FEES <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 /> 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:04/08/2022 1 std_BuildingApplication_pr <br />