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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> lariori . Salem,OR 97305 <br /> County Permit NA FAX:FAX: 503-588-7948 <br /> O'REGON <br /> 555-22-004564-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 FOR 4 BDRM RES <br /> Property Address: Parcel: Owner: RE NO TWO LLC <br /> 2269 Steiwer Rd Se,Jefferson,OR 97352 093W14D 00300- Primary <br /> Address: PO BOX 2882 <br /> WI <br /> LICENSED PROFESSIONAL INFORMATION a <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 /> ,,...RE. .,�FEES <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 450.00 GPD $750.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $850.00 <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:o5/23/2022 1 std_BuildingApplication pr <br /> L <br />