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MARION COUNTY <br /> "$ Building Application 5155 Silverton Rd NE <br /> Salem,OR 97305 <br /> Marion <br /> county Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> OR.E'GON <br /> 555-22-002449-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: E and Z Excavating LLC <br /> PO Box 453 <br /> Molalla, OR 97038 <br /> • ���3..4��.'�Ra£��.�.�.xw �a �' e��,.�,;TYPE.�/�ti�l�Rn � _,. ,._..F __, ., - _ � ''� _ _ _„_ <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Commercial $0.00 <br /> Description of Work: MA]ALT: CHURCH -MOVING DF OFF EASEMENT AND ONTO OWN PROPERTY(AFTER LLA) <br /> Property Address: Parcel: Owner: RUSSIAN OLD BELIEVERS ST <br /> 8702 Parr Rd Ne,Gervais,OR 97026 052W13 01000-Primary NIKOLA CHURCH <br /> Address: 11220 PORTLAND RD NE <br /> SALEM OR 97305 <br /> ' Business Name License Address Phone <br /> E AND Z EXCAVATING LLC Installer 39104 PO BOX 453 MOLALLA OR 97038 (50-3)-829- <br /> License <br /> Fee Description Quantity Amount <br /> Alteration (major) 1.00 Ea $675.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $775.00 <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:03/22/2022 1 std_BuildingApplication_pr <br />