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FOR CITY USE ONLY Received By: Zoning Validation: Date: MARION COUNTY BUILDING INSPECTION COMMUNITY DEVELOPMEI~ CENTER 285 Chuw, h St. NE - Room 132 Salem, Oregon 97301 8:00~m-4:30pm Phone 588-S147 24 hr. Inspe~lion Line 588.7994 FAX ~8~-7948 SITE EVALUATION AND/OR SEPTIC PERMIT APPLICATIO~ 1. LOCATION OF INSTALLATION ~' 2. CONTRACTOR INFORMATION 3. FEES ** Fees include DI~ Suroha~e ($30.00) Site Evaluation, Single Family Dwelling, first lot ......................................................................................................... $320.00 Site Evaluation, Single Family Dwelling, ea addl lot ................................................................................................... ~..235.00 Site Evaluation, Commercial, lust 1000 gallons ............................................................................................................. 320.00 Site Evaluation, Commercial 1000 - 5000 gallons ................................................................ ~ ................... 320.00 + Site Evaluation, Rural Area Varian~ .............................................................................................................................. 320.00 Constm~on Pem~ or Conmmmial Major Repair, first 1000 gallons: Standard Systen~ ................................................................................................................................ 382.00 Capping Fill System ........................................................................................................................... $93.00 Cesspool ............................................................................................................................................. 382.00 Dispo~l Trcac, h in Saprotim .............................................................................................................. 382.00 Evepolranspiration-Absovption System ............................................................................................ .218.00 Cyray Water Disposal Sump ............................................................................................................... 190.00 Pressure Distribution System ............................................................................................................. Redundant System ............................................................................................................................. 382.00 Sand Filter System ............................................................................................................................. 703.00 $~pa~ Pit ......................................................................................................................................... 312.00 Seepage Trench .................................................................................................................................. 382.00 SteepSIopo ........................................................................ , ................................................................ 382.00 Tile Dewatering System ..................................................................................................................... Conslxu~fion Permit or Coram~eial Major Repair, over 1000 gallons: Construction Permit Fee Conmm~ial Plan 600 gallons - 1000 gallons ............................................................................................................... 133.00 Commercial Minor Repair ............................................................................................................................................... 173.00 Single Family Dwelling, Minor Repair (tank only) ......................................................................................................... 130.00 Single Family Dvmll~g, Major Repair (dralnfiald) ........................................................................................................ 210.00 R~id~ntial or commmcial: Alterations .......................................................................................................................................... 378.00 Pmnit Renewal, Field Visit_.,..: ..................................................................................................... 227.00 Permit Renewal, No Field Visit ......................................................................................................... 115.00 Authorization, Field Visit ............... : .................................................................................................. 247.00 Authc~ation, No Field Visit ............................................................................................................ 117.00 Existing Syatem Evaluation ............................................................................................................... 247.00 Annual Evaluation/Alternative System .............................................................................................. 247.00 Annual Evaluation Temporary/Hardahip Mobile Home .................................................................... 183.00 Annual Evaluation, Large Symem ..................................................................................................... 123.00 · Pump or Dosing Siphou ............................................................. ~ .............................. ~ .......................... 25.00 Pumpor Truck Inapec~on, Fir~ Vehicle ................................... ~ ............. ........................................................................... 67.00 Pumper Truck Inspection, Ea Additional Vehicle ............................................................................................................. 40.00 Septic Ralnspoetion Fe~ ..................................................................................................................................................... 25.00 Septic Inspection for which no f~e is specifically indicated .............................................................................................. 40.00/hr gallons + $25/$00 gallons + $25/500 Receipt:. Test Holes Ready: Tank Pumped: Pumping Certification Attached: (Y) (lq)