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FOR- CITY USE ONLY <br />Received Byi. '-~ ~ <br />IZonifig'~' V~idation: __ <br /> <br />MARION COUNTY BUILDING INSI~ ~ I ~7 ~ <br /> COMMUNITY DEVELOPMENT CENTER~I[ <br /> 285 Church St, NE - Room 132 ~ ~ <br /> 2 6 1995 <br /> 8:00am-&3Opm Phone ~88-~147 <br /> ~ hr. ~p~flon Line ~88-7904 <br /> )'AX 588-7948 MARION COUNTY <br /> <br /> SITE EVALUATION AND/OR SEPTIC PERMIT <br />L LOCATION OF INSTALLATION <br /> <br />Subdivision ~ ~m~ ~~ ~l~*~Block~ Ne. Employees. <br /> <br />S~tion ]~ Tow~hip ]O Range i~ ~ ~ne ~ ~ ~ WaterSupply: <br /> ~ Pfivat~ Well ( ) Spring <br /> <br />2. CONTRACTOR INFORMATION <br /> <br /> Site Evaluation, Single Family Dwe ng, tim ut ............................................................................................ $325,00 <br /> Site Evaluatiol~, Single Family Dwe n ,, ea add ut 240 00 <br /> Site Evaluation. Commercial, first 1000 gallons ............................................................................................................. 325.00 <br /> SteEvauaton, Comm~rca 1000-5000ga ons ....................................................................................................... 325.00 + $100/500 gallons <br /> Site Evaluation, Rural Ama Variance .............................................................................................................................. 325.00 <br /> Construction Permit or Commercial Major Repair, flint 1000 gallons: <br /> Standard System ............................................................................................................................... <br /> <br /> Capping Fill System ........................................................................................................................... 598.00 <br /> Cesspool ............................................................................................................................................. 387,00 <br /> Disposal Trench in Saprollte .............................................................................................................. 387,00 <br /> <br /> Gray Water Disposal Sump ............................................................................................................... I95.00 <br /> Holding Tank (Commercial only) .................................. .......... .......................................................... 387.00 <br /> <br /> Redundant System ............................................................................................................................. 387,00 <br /> Sand Filter Syatem .................................................... ......................................................................... 708.00 <br /> Seepage Pit ......................................................................................................................................... 317,00 <br /> Seepage Trench .................................................................................................................................. 387,00 <br /> Steep Slope ......................................................................................................................................... 387,00 <br /> Tile Dewatefing System ..................................................................................................................... 555.00 <br /> Construction Permit or Commeroial Major Repair, over 1000 gallons: <br /> Construction Pennlt Fee + $251500 gallons <br /> Commercial Plan Review <br /> 600 gallons - 1000 gallons ............................................................................................................... 133,00 <br /> lO00galIons.5OOOgallon~ ............................................................................................................... 133.00 + $25/500 gallons <br /> Commcma M orRepar 17 <br /> ................ : .................................................. 8 00 <br /> Single Family Dwellmg, Minor Repmr (tank only) ......................................................................................................... 135,00 <br /> Single Family Dwelling Major Repar (dtalafic d) ........................................................................... 215.00 <br /> Residential or Commercial; <br /> Alterations .......................................................................................................................................... 383,00 <br /> Permit Renewal, Fiel~ Visit .................................................... , .................... 232.00 <br /> Permit Renewal~ No Field Visit ......................................................................................................... 120.00 <br /> Authorization, Field Visit .............................................. , ................................. 252 00 <br /> Authorization, No Field Visit ............................................................................................................ 122,00 <br /> I:txlstthg System Evaluation ............................................................................................................... 252.00 <br /> Annual Evaluation/Alternative System .............................................................................................. 252.00 <br /> Annual Evaluation Temporary/Hardship Mobile Home .................................................................... 188,00 <br /> Annual Evaluation, Large Sy,~tem ..................................................................................................... 128,00 <br /> Pump or Dosing Siphon ....................................................................................................................... 25.00 <br /> Pumper Truck Inspection, First Vehlcle .......................................................................................................................... 102,00 <br /> Pure )er Truck Inspection Ea Additional Veh e e ............................................ 40.00 <br /> <br /> Scl)tic lu~pection t~>r which no fee is specifically indicated .............................................................................................. 40,00/hr <br /> <br />$1gIlaturc of Applicant: ~.lDatel "'/~q '~;}~-- Tank Pumped: <br /> <br /> <br />