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MARION COUNTY <br /> Building Application 5155 Silverton Rd NE <br /> ario Salem,OR 97305 <br /> Mn <br /> County Permit NA 503-588-5147 <br /> FAX: 503-588-7948 <br /> OREGON <br /> 555-24-001360-PRMT <br /> www.co.marion.or.us building@co.marion.or.us <br /> Applicant: CONNOR LT&CONNOR, SEAN R THE <br /> PO BOX 5 <br /> ST PAUL, OR 97137 <br /> 1 1 <br /> ' ��1 �`1: 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: NEW INSTALL FOR FUTURE 3BDRM NSFD <br /> Property Address: Parcel: Owner: CONNOR LT&CONNOR, <br /> 20703 Riverside Dr Ne, St Paul, OR 97137 043W13D 00500- Primary SEAN R THE <br /> Address: PO BOX 5 <br /> ST PAUL OR 97137 <br /> LICENSED PROFESSIONAL INFORMATION <br /> Business Name License Address Phone <br /> PACIFIC NORTHWEST EXCAVATING, Installer 38846 PO BOX 61 WILSONVILLE OR 97070 503-329-5007 <br /> LLC License <br /> Fee Description Quantity Amount <br /> Install -Standard subsurface - by gallons per day 450.00 GPD $1,050.00 <br /> DEQ Surcharge 1.00 Automatic $100.00 <br /> Total Fees: $1,150.00 <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:02/16/2024 i std_BuildingApplication pr <br /> IL <br />