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MARION COUNTY
<br /> 4x
<br /> =. -- Building Application 5155 Silverton Rd NE
<br /> Matron SalemOR 97305
<br /> County f 503-588-5147
<br /> Site Evaluation NA FAX: 503-588-7948
<br /> O.R:E G°O.IJ
<br /> 555-23-005240-EVAL
<br /> www.co.marion.or.us building@co.marion.or.us
<br /> Applicant: AKS ENGINEERING AND FORESTRY
<br /> 3700 RIVER RD N. SUITE 1
<br /> KEIZER, OR 97303
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<br /> No Code Edition Specified
<br /> Type of Work: Category of Construction:
<br /> None specified Commercial $0.00
<br /> Description of Work: SE: OFFICE AND TRUCKER BATHROOM
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<br /> Property Address: Parcel: Owner: EDWARD&DIANNE
<br /> 6800 Le Brun Rd Ne,Woodburn,OR 97071 052W15 00400-Primary FERSCHWEILER
<br /> Address: 6070 HIGHWAY 219 NE
<br /> GERVAIS OR 97026
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<br /> Business Name License Address Phone
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<br /> Fee Description Quantity Amount
<br /> Site evaluation-Commercial facility by design capacity 370.00 GPD $780.00
<br /> gallons per day
<br /> DEQ Surcharge 1.00 Automatic $100.00
<br /> Total Fees: $880.00
<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:06/20/2023 1 std_BuildingApplication pr
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