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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Manor Salem,OR 97305 <br /> county 503-588-5147 <br /> Permit NA FAX: 503-588-7948 <br /> OREGON <br /> 555-21-008569-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Bethel Excavating <br /> PO Box 504 <br /> Turner, OR 97392 <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: 3 BDRM SFD <br /> INFORMATIO[+ z _ <br /> Property Address: Parcel: Owner: GOFFRIER,TIMOTHY S <br /> 2374 Bates Farm Way S,Salem, OR 97306 083W29 00700- Primary <br /> Address: 4367 ORCHARD HEIGHTS <br /> RD NW <br /> SALEM OR 97304 <br /> Business Name License Address Phone - <br /> BETHEL EXCAVATING Installer 36198 PO BOX 504 TURNER OR 97392 (50-3)-743- <br /> License <br /> �.,�.` `". � { -� -.. ,�'� s. <br /> �.;PERI!il "I"IFBES , �,";� 4-� e .�.� _� � 4 � ., <br /> Fee Description - Quantity Amount <br /> Install-Standard subsurface -by gallons per day 450.00 GPD $750.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $850.00 <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:08/25/2021 1 std_BuildingApplication pr <br />