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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> County 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OREGON <br /> 555-23-004256-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: A &B Septic Service <br /> PO Box 444 <br /> Albany, OR 97321 <br /> TYPE OF WORK <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: MIN REP: 3 BDRM SFD (REPL DBOX) <br /> 308 SITE INFORMATION <br /> Property Address: Parcel: Owner: DUPONT, SARAH L <br /> 7490 Bates Rd S, Salem, OR 97306 083W29AD01700 - Primary <br /> Address: 7490 BATES RD S <br /> SALEM OR 97306 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> A&B SEPTIC SERVICE Installer/Pu 38137 PO BOX 444 ALBANY OR 97321 (54-1)-926- <br /> mper <br /> License <br /> PERMIT FEES <br /> Fee Description Quantity Amount <br /> Repair(minor) -single family dwelling 1.00 Ea $305.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $405.00 <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 /> Pnn[ea on 05/19/2023 1 <br /> std—BuildingApplication pr <br /> . <br />