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MARION COUNTY <br /> Building Application 5155 Sllverton Rd NE <br /> Salem,OR 97305 <br /> Nanion <br /> county Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> ;q:R E G R N <br /> 555-24-003589-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: Lone Pine Corner Septics Inc. <br /> 8778 Cascade Hiahway. NE <br /> Silverton, OR 97381 <br /> s <br /> No Code Edition Specified <br /> Type of Work: Category of Construction: <br /> None specified None specified $0.00 <br /> Description of Work: MAJ REPAIR-REPLACE 2 SFD WITH SAME <br /> Property Address: Parcel: Owner: REYNOLDS, LOREN A <br /> 9535 Elkhorn Woods Cir Se, Lyons,OR 97358 093E02DC00500-Primary <br /> Address: 40 R <br /> tar: A25 L SCHAFER R 7305D NE <br /> roan .p .�. r ..�jii i;r0or 3 ,,._:` .,s y ,4, <br /> Business Name License Address Phone <br /> LONE PINE CORNER SEPTICS INC. Installer 37003 8778 CASCADE HIGHWAY,NE SILVERTON 503-873-7157 <br /> License OR 97381 <br /> as ' <br /> Fee Description Quantity Amount <br /> Repair(major)-single family dwelling 1.00 Ea $640.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $740.00 <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:05/08/2024 1 std_BuildingApplication_pr <br />