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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> 'Nano' J1 Salem,OR 97305 <br /> COWitlf 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OREGON <br /> 555-22-008152-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Oregon Sewer&Drain <br /> PO Box 1282 <br /> Silverton, OR 97381 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Commercial $0.00 <br /> Description of Work: INSTALL: HOLDING <br /> TANK"A" <br /> - iar:VZ b<3 0p SITE I <br /> INFORMATION <br /> Property Address: Parcel: Owner: MARK D STADELI LT& <br /> 12424 Silverton Rd Ne,Silverton,OR 97381 061W33D 01000-Primary STADELI, MARK D THE <br /> Address: PO BOX 832 <br /> I S' Z Z x .. '� ,.. a...FO _._ , ,, �*SILVERTO OR 97381 �.c .......: <br /> Business Name License Address Phone <br /> OREGON SEWER&DRAIN Installer/Pu 38968 PO BOX 1282 SILVERTON OR 97381 (50-3)-874- <br /> mper <br /> License <br /> Fee Description Quantity Amount <br /> Install-Holding tank -by gallons per day 1.00 GPD $705.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $805.00 <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:09/08/2022 i std_BuildingApplication_pr <br />