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MARION COUNTY <br /> ti- Building Application 5155 Silverton Rd NE <br /> Nat• <br /> ion . Salem,OR 97305 <br /> 503-588-5147 <br /> County <br /> Permit NA FAX: 503-588-7948 <br /> O.R.E G:ON" <br /> 555-23-003253-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Flow Line Construction LLC <br /> 11805 State St <br /> Salem, OR 97317 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: NEW INSTALL FOR 2 BDRM SFD <br /> r B .rr ;� b�W h At g�° RMATi N 4 <br /> ..,... �� .. . ,..fxs. <br /> Property Address: Parcel: Owner: DAHL, ERIC <br /> 6836 Silver Ridge Rd Se, Sublimity,OR 97385 081E23 00200- Primary <br /> Address: S 16984E HERIGSTADRTONOR97381 <br /> RD <br /> av ' i z `)E.ICE D PRO ESSI NAIL INFO ATION uff <br /> Business Name License Address Phone <br /> FLOW LINE CONSTRUCTION LLC Installer 39474 11805 STATE ST SALEM OR 97317 (50-3)-871- <br /> License <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 1.00 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:04/20/2023 1 std_BuildingApplication pr <br />