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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> Copy Permit NA503-588-5147 <br /> FAX: 503-588-7948 <br /> OR.E' G' O N <br /> 555-22-010904-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Owen Construction, Inc. <br /> P.O. Box 21150 <br /> Keizer, OR 97307 <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 /> Property Address: Parcel: Owner: VIRGINIA L RIPP TR <br /> 5362 70Th Ave Se,Salem, OR 97317 082W15AC00600-Primary <br /> Address: PO BOX 515 <br /> __ y r _} _ T LICENSED PROFESSIONAL INFO ATION k STAYTON OR 97383 <br /> Business Name License Address Phone <br /> OWEN CONSTRUCTION,INC. Installer 38534 P.O.BOX 21150 KEIZER OR 97307 (50-3)-390- <br /> License • <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 450.00 GPD $1,010.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> • Total Fees: $1,110.00 <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 /> arinted on: 1z/oi/zozz 1 std_BuildingApplication.pr <br />