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Received By;; ~, Senator Bldg, No,~5 <br /> <br /> Phone;; ........ Mailing Address;; ........ <br />Plu~in~ Inst~ller; :" ~one:: Address::' <br /> <br />Home ~ii~v~ ~e~e~fion No,: .... <br /> <br />Commemial;; ~ Alteration ~ Reio~tJon:: ~ Change;: ~ ~>~ <br /> <br /> NO, FEE AMOUNT <br /> Base Pri?, $20.00 <br /> Residential ...... <br /> New constructioe each flxt~re! ....... ' ..... $ 9,00 <br /> Alterations (~a~h fixture) 900 <br /> Re-loc. ated Residence (each fixture) ...... 4,50 <br /> ....... C, ommerciel <br /> New C~,structi~n (each fixture), ,, '"' ~'~00' <br /> Altera!ions (each fixture) ,,, ' .......9.00 <br /> Water Lines ........ ' ....... <br /> For the first 100 feet or fraction thereof ,, ,,/ ........... 20 0~' ' ~.,,,#-'&) <br /> For additional 100 feet 15,,00 <br /> Sewer Service Lines <br /> Firet 100 feet or fraction the'~of ...... '" j 3000 ..... ~'~, <br /> Additional 100 feet 1500 <br /> Mobile H~,me sewer/water connection <br /> (maximum,5 feet length 25,'~'0 ' <br /> Other (~s per OSPSC aed,B~ildlng Official) "' <br /> On-Site Technical Review apply at,Marion co~lty only) ,,, '" ' <br /> Re-lnsp.~,ctlon Fee 2500 <br /> <br />STATE SURCHARGE <br />PLAN REVIEW FEE $ <br />INVESTIGATION FEE $ <br />Please return COMPLETE APPLICATION FLEET SURCHARGE $ <br />with the indicated fee, CiTY FEE $ <br />TOTAL <br /> <br /> ).~m performing work on a property I own or o~cupy <br /> I am a registered builder OR ( ) the auth0rized representative of SIGNATURE OF APPLICANT <br /> eglstemd builder, <br />(~,,'~ The wo~'k will be performed by a regis~md builder, <br /> Other <br /> I agree to install according to the submitted plans ~nd speclflcatlons~ the laW~ of the state of Oregon and the ordinances of Marion County <br /> <br />MC 1~-45 <br />Rev, 12/87 <br /> <br /> <br />