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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Salem,OR 97305 <br /> Marion <br /> County Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-21-000257-PRMT <br /> www.cc.marion.or.us building@co.marion.or.us <br /> Applicant: Bethel Excavating <br /> PO Box 504 <br /> Turner, OR 97392 <br /> TYPE OF WORK • <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified Single Family Dwelling $0.00 <br /> Description of Work: FIRE - MA] REPAIR TANK AND DRAINFIELD <br /> 3OB SITE INFORMATION <br /> Property Address: Parcel: Owner: KAHLE,TIM R <br /> 11078 Dogwood Ln Se, Lyons, OR 97358 093E18BA00100 - Primary <br /> Address: 11078 DOGWOOD LN SE <br /> LYONS OR 97358 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> BETHEL EXCAVATING Installer 36198 PO BOX 504 TURNER OR 97392 (50-3)-743- <br /> License <br /> 441 <br /> Fee Description Quantity Amount <br /> Repair(major) -single family dwelling 1.00 Ea $600.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: • $700.00 <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:01/11/2021 1 std_BuildingApplication_pr <br />