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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> 1 i. on- Salem,OR 97305 <br /> county Site Evaluation NA 503-588-5147 <br /> O`B E G O N FAX: 503-588-7948 <br /> 555-19-002155-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> ********* PERMIT HAS NOT BEEN ISSUED ********** <br /> � �, ..; ,s: .,; ,.. � ..N T�G��=r0•RA a .� M �"';.. ,a.,.,. �Y„ ��,3 _,,, s a <br /> Tvoe of Work: Category of Construction: <br /> Residential <br /> Description of Work: SE FOR FUTURE REPAIR AREA EASEMENT FOR 22604 MILK RANCH RD <br /> y 4� <br /> �.. �t., _2 .... .._ ii::1 ,�...�.. ,..,, .- '�_ �, �,;;' �,,:-.��OS�STT� NOI�M;�►'T�QNy��,��.� ;���� � ���r = , �._. .. . . .ff _. <br /> Property Address: Parcel: Owner: R M BUTSCH RT <br /> 22610 Milk Ranch Rd Ne,Scotts Mills,OR 97375 072E20BA00400-Primary <br /> Address: PO BOX 277 <br /> INDEPENDENCE OR 97351 <br /> ._.. ,6' _ 9 „$ L KENS 1t PROFESS f NAL�.IN.FOE MATION g �. gy m. <br /> Business Name License Address Phone <br /> ON-SITE SEPTIC AND EXCAVATION LLC Installer 36786 P.O.BOX 5241 SALEM OR 97304 (50-3)-362- <br /> License <br /> REQU RED NSP CT t N <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.buildingpermits.oregon.gov or by calling: 1-888-299-2821 <br /> When calling for an inspection, use IVR Number: <br /> OR search"ePermitting"at the Apple App Store to download the Oregon ePermitting Inspection App for iOS. <br /> OR search"ePermitting"at the Android App Store to download the Oregon ePemiitting Inspection App for Android. <br /> �,r, gi <br /> ,P <br /> ,.,"rts.���',KI�N..av,.+'��.�d a+n.L, <br /> Fee Description Ouantitv Amount <br /> Site evaluation-Single family dwelling 1.00 Ea $625.00 <br /> DEQ Surcharge 1.00 Automatic $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:03/25/2019 1 <br />