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MARION COUNTY <br /> Building Application <br /> 5155 Silverton Rd NE <br /> Salem,OR97305 <br /> 503-588-5147 <br /> County Permit NA <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-20-009195-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> • <br /> Applicant: Lone Pine Corner Septics Inc. <br /> 8778 Cascade Hiahway. NE <br /> Silverton, OR 97381 <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: FIRE: MA) REP: 2 BDRM. PRIMARY <br /> Property Address: Parcel: Owner: WEISE,DALE J <br /> 123 E Sorbin Ave,Gates,OR 97346 093E26CC01800-Primary <br /> Address: 123 E SORBIN AV <br /> GATES OR 97346 <br /> ucENSi D PROFE <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 /> PERMXT FEES .: <br /> Fee Description Quantity Amount <br /> Repair(major)-single family dwelling 1.00 Ea $600.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $700.00 <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:12/18/2020 1 std_BuildingApplication_pr <br />