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MARION COUNTY <br /> "• Building Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> County Permit NA503-588-5147 <br /> FAX: 503-588-7948 <br /> O.R.E G O.N <br /> 555-23-003659-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: N WILSON CONSTRUCTION LLC <br /> 32325 NORTH FORK RD SE <br /> LYONS, OR 97358 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: MAJ REPAIR-FAILING SYSTEM <br /> Property Address: Parcel: Owner: KOHL, MICHAEL S&KOHL, <br /> 1045 Oak St,Silverton,OR 97381 061W35AB00800-Primary DAWN M 33.3% <br /> Address: PO BOX 127 <br /> SILVERTON OR 97381 <br /> �� � ', LIGENSEb PROFESSTONAI_.;TNFORATION � � w ��k�, s,, <br /> Business Name License Address Phone <br /> • N WILSON CONSTRUCTION LLC • Installer 39602 32325 NORTH FORK RD SE LYONS OR 503-849-8967 <br /> License 97358 <br /> �y <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:05/04/2023 1 std_BuildingApplication_pr <br />