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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> MarlonSalem,OR 97305 <br /> County Residential Septic - DEQ 503-588-5147 <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-16-003737-SEP <br /> www.co.marion.or.us building@co.marion.or.us <br /> ********** PERMIT HAS NOT BEEN ISSUED ********** <br /> Tvoe of Work: Cateoory of Construction; <br /> Site Evaluation with Site Visit Single Family Dwelling <br /> pescriotlon of Work; SE FOR FUTURE 4BDRM RES 2 AC PARCEL 1 OF 5 PLA 15-019 <br /> �a4sh.- 7f��..,x _ �t�.. ��� -.,,�. mot... <br /> Property Address: Parcel: Owner: DAVID J BIELENBERG <br /> 11484 Hazeigreen Rd Ne,Silverton,OR 97381 TEMP MC-Primary <br /> Address: 16425 HERIGSTAD RD NE <br /> SILVERTON OR 97381 <br /> Business Name License Address Phone <br /> ` >...• '. :S_., r�' -- _ L'i r 744,7t4 .f,'a.�-acfN?i r....._. m � :�"�,. '_'�;_ i.�-rscsx.-_0144- 4,.4.. .&'. <br /> The list of inspections below represents the inspections required for this project at the time of permit printing. Additional inspections may be <br /> required through the life of the project. You will receive notification of any additional inspection requirements for project completion. All <br /> required inspections must be completed and approved. <br /> Schedule Inspections online at www.bulldingpermits.oregon.gov or by calling: 1-888-299-2821 <br /> When calling for an inspection,use IVR Number: <br /> vim! ;4 '' �i:lL7:I � �:a '�y.,��'�"�'z `" s .�sc}�.»� ° ,�'-.,kCs' �i a <br /> ., .. T, .. .+R _..-��G �is3' .`a"`i '.Y:, .. _.'ems,. - <br /> Fee Description Quantity Amount <br /> Site evaluation-first lot 1.00 Qty $625.00 <br /> DEQ surcharge 1.00 Ea $100.00 <br /> Total Fees: $725.00 <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. Granting of a permit does not presume to give authority to <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. <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:05/26/2016 1 <br />