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n, ,,; MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> friar/on . Salem,OR 97305 <br /> County 503-588-5147 <br /> 4tt <br /> Permit NA FAX: 503-588-7948 <br /> ,EG O^N. <br /> 555-24-001686-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Dwain Bethel &Sons Excavation, Inc. <br /> PO Box 504 <br /> Turner, OR 97392 <br /> . . 711 3,;3:p,:,,;:f,, .'.7.:6;r. , vrt woo <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: NEW INSTALL 4 BDRM SFD <br /> Vems kr ,%•t°, <br /> Property Address: Parcel: Owner: HORNSTRA,JAIME <br /> 6261 4-J Ln Se,Salem,OR 97317 082W21 00400-Primary <br /> Address: 4238 CLOUDVIEW DR S <br /> SALEM OR 97302 <br /> Business Name License Address Phone <br /> DWAIN BETHEL&SONS EXCAVATION, Installer 36198 PO BOX 504 TURNER OR 97392 503-743-2343 <br /> INC. License <br /> • . . ...,... .. We 17 v '. ,:a . .. '? <br /> Fee Description Quantity Amount <br /> Install-Standard subsurface -by gallons per day 450.00 GPD $1,050.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,150.00 <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:03/01/2024 1 std_BuildingApplication_pr <br />