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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> County 503-588-5147 <br /> Site Evaluation NA FAX: 503-588-7948 <br /> OREGON <br /> 555-23-009651-EVAL <br /> www.co.marion.or.us building©co.marion.or.us <br /> Applicant: LONE PINE CORNER SEPTIC INC <br /> 8778 CASCADE HWY NE <br /> SILVERTON, OR 97381 <br /> m Per <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: SITE EVAL FOR FUTURE 5BDRM SFD <br /> . .. �: ' <br /> •x,. �� >x� ,✓, age ��,. ,...�� �._.�� � ..,>, .k,,< <br /> Property Address: Parcel: Owner: DIAMOND SPRING RANCH <br /> 56-3oseph St Se, Salem, OR 97317 082W10C 01400- Primary LLC <br /> (071'10 Address: 5125 WITTENBERG LN NE <br /> KEIZER OR 97303 <br /> Business Name License Address Phone <br /> • <br /> 3 :, ulc� oe .5�-u`� 3R' p �w- '^ .x� *nTao-., <br /> Fee Description Quantity Amount <br /> Site evaluation -Single family dwelling 1.00 Ea $810.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $910.00 <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 11/22/2023 1 std_BuildingApplication pr <br />