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�.., <br /> MARION COUNTY <br /> Building Application 5155Si1vertonRdNE <br /> Mn Salem,OR 97305 <br /> County 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OR.EG:0N <br /> 555-22-006642-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: CAC Excavation, Inc <br /> 9669 SE Wallace Rd <br /> Dayton, OR 97114 <br /> M :. Pv s ,7.; '� ` - -� TYI�I�.t '' QItC aF x Y 4a' 't3` ` ,�¢ � " - - x <br /> ,., .�1 '.,,.,.., z�,.a>,-__,,.,,,. „_-_< .,,,. ,���; :9- ..a .�.,-_,•____ ..,. Pam., - ,.,.�,�.�., r;,;�„ ,,, - _ �"�_:t ,E <br /> _.., ter' ->_„_,. �� '� -- �. <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Manufactured Dwelling $0.00 <br /> Description of Work: MA] REP: 3 BDRM MH -2ND FARM DWELLING <br /> Property Address: Parcel: Owner: NYQUIST, BARBARA <br /> 20267 Butteville Rd Se,Hubbard,OR 97032 041W19A 00900-Primary <br /> Address: 20265 BUTTEVILLE RD NE <br /> HUBBARD OR 97032 <br /> . CE,lu l PRO I OVAL. NFORMAt ON g . <br /> Business Name License Address Phone <br /> CAC EXCAVATION,INC Installer 39050 9669 SE WALLACE RD DAYTON OR 97114 (50-3)-550- <br /> License <br /> Fee Description Quantity Amount <br /> Repair(major) -single family dwelling 1.00 Ea $600.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $700.00 <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:07/26/2022 1 std_BuildingApplication_pr <br />