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FOR CITY USE ONLY MARION COUNTY BUILDING INSPECTION ..~ .. COMMUNITY DEVELOPMENT CENTER · ~ ............. Salem, O~gon ~30 I Z ,ning Validation: ~ 8:00a~-4~pm Phone ~88-,147 Date ~{~{~ ~ hr. Impecfion Linc 588-7904 ~ ........... I PAX SSS.79~S SITE EVALUATION ANO/OR SEPTIC 2. CONTRACTOR INFORMATION !' 3, FEES Mailing Addms~ Phon* No, Site Evaluation, Single Falno~ly Dwelling first lot ......................... .$325,00 Site Evaluation, Single Family Dwelling, ea addl lot ...................................... : ............................................. 240 00 Site Evaluation Comme.~ial first I0(30 gal ohs ................................................................ ' ................. 3::5'00 Site :~valuation, Rural Area Variance ............................................................... ............................................................... (2omtmction Permit or Commemlal Major Repair, first 1000 gallons: Standard Systom ................................................................................................................................. 387,00 Aerohlc System .................................................................................................................................. ::23.00 Capping Fill System ........................................................................................................... 598 00 Disposal Trench in Saprotit~ ............................................ Evapotranspiration-Absorption System ............................................................................................. Gray Water Disposal Sump ...,..i ....................................................................................................... 195,00 Holding Tank (Commerola on y) ...................................................................................................... 387.00 Seepage~ Pit ........................................................................................ .; ................................................ Se*page Trench ......................................................... ...,..,.: .............................................................. 387.00 Steep Slope ......................................................................................................................................... 387,00 Tile D~watefing System ..................................................................................................................... Constraefion Permit or Commercial Major Repair, owt 1000 gallons: Construction Permit Fee + $25[$00 gallons Commomlal Plan Revlew 600 gallons - i000 gallons ............................... . ......................... 13g.00 1000 gallons - $000 ga ions ................................................ ; .............................................................. 133.00 + $25/500 gallons Conm~e~ a M nor Repa r ......... . ..................................................... moo Single Family Dwelling. ~ii~or ~*'~'~;"~;~:;~i~'~JTiTgJgi55?glTgigJZgigJgiglJgJgJglT~Tg?Ti22222.jgll .................................................... glnglo Family Dwelling, Major Repair (dralnfie d) ........................................................................................................ 215.00 Residential or Commercial: Alterallons ............................... i ............................ , ........................................................ 383.00 Permit Rcncwa~ No Field Visit ........................ Authofixatlon. Field Visit ................................................... , ...................................... 252100 Au horiza on, No Pie d V s t ............................................................................................................ 122.00 Existing System Evaluation ............................................................................................................. 252.00 Annual l~va uafion/A tematlve System ................. : ............................................................................. 252,00 Annual Evaluation Temporary/Hardship Mobile Home .................................................................... 188.00 Annual Evaluation Larg~ System 28 00 Pump or Dosing Siphon ....................................................................................................................... 25.00 Pumper Truck Inspection, First Vehicle ......................................................... : ............................................................ 102.00 Pu riper Truck Inspect on, Ea Add t olin Veh ¢ e ............................................................................................................. 40,00 sep~}c Ral~p,¢tion F,o ................................. , .................. Septic Inspection for which no fee is specifically indicated ............................... ......................................................... 40 Signature°fAppiiea'"~i~ f'~~" Date, Tank Pumped: ' m,----' ' . ' ~ ~ Pompmg Cer~lflcatmn Attach*d: fY) (N)