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S:00am.4:30pm Phone g58-S147 ~4 hr. In~p~ctlon Line SSS-7904 ~ARION COUNTY PAX 58g-7945 ~NSPECTION SITE EVALUAT,ON AND/OR SEPTIC PERMIT APPLICAT~a~D'~ ~_ t S~ 1. LOCATION OF ~STALLATION ...... Phone No · Section Township~ ....... Range I ~ae ~ ~ Map ..... ~va~Wamr Safely;Well ..... Co~u~ty Well City 2. CONTRACTOR iNFORMATION 3. FEES Mite Evaluat~oo, Commerelal 1000 - 3000 gallons .......................................................................................................... 325.00 + $100/500 gallons Mite EYaluagon, Rural A~a Variance ............................................................................................................. ................. 325.00 Constraotlon Permit or Commercial Major Repair, first I0O0 gallons: Standard System ................................................................................................................................. 387.00 Aerobic System .................................................................................................................................. 223.00 Capping Fill System ............ , .............................................................................................................. 598.00 Cesspool ........................................................................ ; .................... ................................................ 387.00 Di*posal Trench n Saprolita...... ....................... . ............................................................................. 387.00 //vapotranspiration-Absorption System ........................ ; .................................................................... 223.00 Gray Water Disposal Sump ......................................... ;.,,,,: ......................................................... 195 00 Holding Tank (Commercial only) ................................. ; ................................................ :;]:;] ............. 387:00 Pressur~ Distribution Syst/mt,.. ......................................................... ................................................ 555.00 Redundant gystar~ .............................................................................. , ............... 387.00 Sand Fi1 er System ................................................................. ~ ........................................................... 708.00 Seepage Pit ......................................................................................................................................... 317.00 Seepage 'l~ene21 ............................................................. ~ .................................................................... 387,00 Steep Slope ................................ ......................................................................................................... 387,00 Tile Dewate~ng System ..................................................................................................................... 555,00 Consttuation PerrMt or Cornmei~ial Major Repair, over 1000 gallons: Constraetlon Permit Fee +$25/500gallol~s Comrne, r¢iaI PlaR Review 600 gallons - 000 ga OhS .......................................................................... 133.00 1000 gal ods - S000 ga on$ ............................................................................................................... IS3,00 + 595/$00 gallons Common:iai Minor Rep;fi? ................. : ............................................................................................................................. 17g,00 Singje Family Dwelling Minor Repair (tank on y) ................................... ~ ................... ;,.; ............ ; .................... .....,.i,. $~ngle Family DwelIing, Major Repair (drainfield) .................................... ! ................................................................ ~ Rcs dentiaI or Commercial: Alterations ....................................................................................................................................... .,.383.00 Permit Renewal, F/¢ d V s t ................................................; ..................... ......................... .............. 23%00 Permit Renewal, No Field Visit ................................................... , ........................... 120,00 Authorization, Field Visit .................................................... , ..................................... 25Z00 Authorization No Field Vlsi ,,; .................................................................. 1222,0000 Existing gys~m Evaluadon ............................................................ ................................................... 23 , Annual EYalaatlon Temporary/Hardship Mob e Home ................................................................. 185.00 Annual Evaluat!on, Lm-g~ System ..................................................................................................... Pump o~ Dosing S~phon ........................................................ ............................................................ ~ Pamper Truck Inspection, First Vehicle ...................................................................................................................... 10Z00 Pa ~er Truck I sp~c on, Ea Add t ona Veh c e ............................................................................................................. 40,00 Septic Inspection for wh{ch no fee is sp~cihc~lly indicated .............................................................................................. 40,00/hr Oo,q ' D. /°n Tank Pumped: Pumping Certification Attached; (y) (N)