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Marion County <br /> Septic Authorization Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> Country! 503-588-5147 <br /> 555-24-003296-AUTH Building@co.marion.or.us <br /> O,R.E ON <br /> Residential Authorization Website:co.marion.or.us <br /> " �i��.�a; i �,�-: �C prN�` 4�."u yr �e ' �°` S��w'��ba�+"",r;�d <br /> AppIilration4 iration D €14/26/2025, r k� A. - A a 1VZ,Vif t zrr4 <br /> , � � tea, " . °°�y�� ., Hk:. <br /> W RDescri CON*INEC TFUTUR BDRM SFD INTT� E *6� <br /> �ptl�rt � �,� �, � I��FflI��XISTIN 48�.P � �FCt`'lk};i1�7'SILL,CHAtG <br /> x „r'"F �tat i �� s � s � -r � <br /> Applicant: BURNS,THOMAS R&BURNS, Primary Contractor: OSE541 LLC <br /> ROXIELLIA L Installer License: 39705 <br /> Address: 2611 JORY HILL RD S Address: 40110 Providence Dr <br /> SALEM OR 97306 Solo Or 97374-9736 <br /> Phone: 503-949-2798 Phone: 541-362-7000 <br /> Email: ROXBURNS333@GMAIL.COM Email: kiel.brown@jacobs.com <br /> Owner: BURNS,THOMAS R&BURNS, Property Address: 2611 Jory Hill Rd S, Salem,OR 97306 <br /> ROXIELLIA L <br /> Address: 2611 JORY HILL RD S <br /> SALEM OR 97306 <br /> Parcel:083W20B 01400-Primary <br /> Accessory Dwelling Unit: N/A- - - <br /> Authorization Notice for: Other <br /> Lot Size: N/A Water Supply: Well <br /> Category of Construction: Single Family Dwelling <br /> Number of Bedrooms: 4 7 <br /> • <br /> CALL BEFORE YOU DIG...ITS THE LAW <br /> ATTENTION:Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth by Oregon Administration Rules.You may obtain <br /> copies of the rules by calling the center.(Note:The telephone number far the Oregon Utility Notification Center is 1-800-332-2344.) <br /> 4/29/24:8:17:02AM Page 1 of 1 ONS_OnsiteAuthorizationApplication_pr <br />