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m/litt;4,,-„z„ MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marwn Salem,OR 97305 <br /> County Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> O:R.E'.GO.N <br /> 555-23-004252-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: American On Site <br /> 31881 S Hwy 213 <br /> Molalla, OR 97038-0857 <br /> '" <br /> s - +c a,�.� �' Y _ s r � �- "fir° t - ^s <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Commercial $0.00 <br /> Description of Work: NEW INSTALL: HOLDING TANK FOR OFFICE <br /> Property Address: Parcel: Owner: WOODBURN STORAGE OZ <br /> 680 S Pacific Hwy,Woodburn, OR 97071 051W19A 00300-Primary LLC <br /> Address: 2448 SW COMMONWEALTH <br /> AVE <br /> PORTLAND OR 97201 <br /> i ,s N" 5 ' y" . 0144(S pROEESSI:45N*L*INFQRMAtt:4 <br /> Business Name License Address Phone <br /> AMERICAN ON SITE Installer/Pu 38346 31881 S HWY 213 MOLALLA OR (50-3)-209- <br /> mper 97038-0857 <br /> License <br /> .. <br /> �. , a � �g6 a PEIRMIT`EEES 3fi � �h <br /> Fee Description Quantity Amount <br /> Install-Holding tank -by gallons per day 1.00 GPD $705.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $805.00 <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:05/19/2023 1 std_BuildingApplication pr <br />