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ni„,,� MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> Marion Salem,OR 97305 <br /> CountyPermit NA EXP I REF . 503-588-503-588-7947948 <br /> OREGON <br /> 555-21-011231-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 /> TYPE OF WORK <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 2 BDRM HOME <br /> JOB SITE INFORMATION <br /> Property Address: Parcel: Owner: BRAUSCH, SHANE <br /> 5905 D St Se,Turner,OR 97392 092W33BD01000- Primary <br /> Address: 5905 D ST SE <br /> MARION OR 97392 <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 /> „J," ,e N71'470 4 �. sue_ iP <br /> PERMIT FEES <br /> Fee Description Quantity Amount <br /> Install -ATT-by gallons per day 450.00 GPD $990.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,090.00 <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: 11/10/2021 i std_BuildingApplication pr <br />