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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Salem,OR 97305 <br /> CountyPermit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> G. 0 <br /> 555-23-000929-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: NOBLE BUILT HOMES LLC <br /> PO BOX 571 <br /> SILVERTON, OR 97381 <br /> TY1�E OF WORK _. ..._.... ; <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: NEW INSTALL FOR REPLACEMENT 5 BDRM SFD <br /> SITE INFORMATION: ,.. <br /> Property Address: Parcel: Owner: JENNINGS,BARBARA <br /> 5375 Howell Prairie Rd Se,Salem,OR 97317 082W13 01200- Primary <br /> Address: 537 MYRTLE DR <br /> n 7 ? 0 ti ENSED PROFESSIONAL INFORMATION ..__.._.__' _.� 7-7 <br /> Business Name License Address Phone <br /> LONE PINE CORNER SEPTICS INC. Installer 37003 8778 CASCADE HIGHWAY,NE SILVERTON (50-3)-873- <br /> License OR 97381 <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 525.00 GPD $1,010.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,110.00 <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:02/01/2023 1 std_BuildingApplication.pr <br />