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IFOR CiTY USE ONLY MARION COUNTY BUILDING <br /> · COMM, , IT¥ ,EVfi, O,'Mfi CE ' <br /> <br /> ~ .... ~ / I ~ ~ 24 hr l~pecflon Line 588-79~ <br />/ ........ ' '" ,,, v~x sss-~gas <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />2. CONTRACTOR INFORMATION <br /> <br />Auth, Agent/Leaaee <br /> <br />3. FEES <br /> <br />Mailing Address Phon~ No, <br /> <br /> Site Evaluation, Commercial first t000 gallons ............................................................................................................. 325,00 <br /> Site Evaluation, Commercial 1000 - 5000 gallons .......................................................................................................... 325,00 <br /> <br /> Standard System ................................................................................................................................. 387,00 <br /> Ac:robie System ............................................................................................................ 223 00 <br /> Capping Fi System ................................................. : ......................................................................... 59g.00 <br /> Cesspool ............................................................................................................................................. 387,00 <br /> <br /> l-lolding Tank (COmmerc a on y) ........................ ~ ............................................................................. 387,00 <br /> Pressure Distribution System ............................................................................................................. 555.00 <br /> <br /> Seepag~ Pit ......................................................................................................................................... 317,00 <br /> Seepage Trench .................................................................... i ............................................................. 387,00 <br /> Steep Slope.,,.,; ............................................... , ................... 3875.00 <br /> ri e Dewaterlng Syslem ..................................................................................................................... 55, .00 <br /> Construction Permit or Commercial Major Repair, over 11300 gallons: <br /> Construction Pennlt <br /> Commercial Plan Review <br /> 600 gallons - 1000 gallons ........... .,,.,..,133,00 <br /> 1000 gallons - S000 gallons .................................. ................ i ................................................ 1.11.,,,..133.00 <br /> Commemlal Minor Repalr ............................................................................................................................................... 178.00 <br /> Single ~atnily DwellingS. Minor Repair (tank only) ................................................................................. 135.00 <br /> Single Family Dwelling, Major Repair (drainfie d) ........................................................................................................ 215,00 <br /> Rc,sidentlal or ¢ommemlal; <br /> Alt.rations ' ! 383 00 <br /> <br /> Authotizatlon, Field Visit ............................................................. 252,00 <br /> Auh rza o .NoF~dVs ............................................................................................................ 122.00 <br /> l~×isting System J~valuation ........................................ , ........... ........................................................... 252,00 <br /> Annual Evaluatio. TemgormyAqan;iship Mobile Home . ................................ 188,00 <br /> Annual Evaluation, Large System ..................................................................................................... 128.00 <br /> Pomp or Dosing Siphon ..................................................... :12 .............................................................. 25,00 <br />Pumper Track Insp¢etlon. Firat Vehi¢Ie .......................................................................................................................... 102,00 <br /> <br />Septic Reinsp¢¢tioB Fe~ ............................... 25 00 <br /> <br />+ $100/500 gallons <br /> <br />+ $25/500 gallons <br />+ $251500 gallons <br /> <br />Tank Pt~nlped: <br /> Date <br /> <br />Pum*in~ Certification Attached: (Y) <br /> <br /> <br />