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MARION COUNTY <br /> - Building Application 5155 Silverton Rd NE <br /> MarionSalem,OR 97305 <br /> county 503-588-5147 <br /> Site Evaluation NA <br /> FAX: 503-588-7948 <br /> OR;E G;O,N <br /> 555-23-006562-EVAL <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Ole Bergman Excavating, Inc. <br /> 1901 S church St <br /> Dallas, OR 97338 <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: SE FOR FUTURE 4 BDRM SFD <br /> Property Address: Parcel: Owner: KARLEN,AARON I <br /> 15083 Huiras Ln Ne,Silverton,OR 97381 071W12 00700-Primary <br /> Address: 15083 HUIRAS LN NE <br /> SILVERTON OR 97381 <br /> ",, .. su.✓ %�.�,'.,.�ag -:dam. M.:.. ....x me�..'".'�� n. am.O, a ' a :,.. u =';"b" ✓ Ys L.�zmei.; ,.._..va..s.,e..sea.,w� "` <br /> Business Name License Address Phone <br /> OLE BERGMAN EXCAVATING,INC. Installer 38311 1901 S CHURCH ST DALLAS OR 97338 503-508-3414 <br /> License <br /> ::,4, <br /> Fee Description Quantity Amount <br /> Site evaluation-Single family dwelling 1.00 Ea $810.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $910.00 <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:08/04/2023 1 std_BuildingApplicationjr <br />