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IiFOR CITY USE ONLY <br /> <br /> ~cc!vc~ I~y:, _ ...... <br /> oning Vatidatiom <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY Dff~ELOPMENT C~R <br /> ~:5 C'hur~h St. NE - l~m 139 <br /> galcm. Oregon 9~301 <br /> <br /> SITE EVALUATION AND/OR SEPTIC PERMIT APPLICATION <br />LOCATION OF INSTALLATION <br /> <br />CONTRACTOR INFORMATION <br /> <br /> Sita ~va ua'ion. Cora m~v,L~l I000 - ~ gallons ...................................................................................... 3~ <br /> <br /> Auwb{~ Sy~m .................................................................................................................... 2~.~ <br /> <br /> l,loidln{ Ta~ (~ on y) ...................................................................................................... ~87,~ <br /> ~e~u~ ~s~buo~ Sys~m ........................................................................................................... 555.~ <br /> <br /> ~?1o~,,: ..................................................................................................................................... ~ O0 <br /> <br /> ~ ........................................................................................................................... 17K~ <br /> ~iail¢ P~ily ~llin$, Major ~ir (~nfield3 ..... <br /> <br /> ................................................................................................... 383.~ <br /> ~t: ~wal. No ~eM Visi{ ...................... . ...............1 ~ <br /> l~}nfioa Held vait .................................... , ................. ~2 <br /> <br /> Pu ...... ' ~' -- ' ..................................................................................................... <br /> <br />Pool~r'l¥~k {ns~iion F~ A~ ohm V~ ¢ e ................................... <br /> <br />3- FEES <br /> <br />+ $~1500 gallon~ <br /> <br />4. $2~/500 gallor~ <br /> <br />~F~ Pumping Cexti fi~tion Attached: ~ (N) <br /> <br /> <br />