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IZoni~g Validation:' <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> co . a, TV D VELOF m C TER <br /> <br /> Salem, Oregon 97301 <br /> 8:OOam-4:3Opm Phone 588-5147 <br /> 24 hr. Inspection Line 588-7904 <br /> FAX 588-7948 <br /> <br />1. LOCATION OF INSTALLATION <br /> <br />I Mailing Address ~. <br /> <br />Tax Acct No. <br /> <br />Block <br /> <br />r~g. Lot Comer <br /> <br />Mailing Address <br /> <br />Mailing Address <br /> <br />Mailing Address <br /> <br />No. Employees ~] ,Of <br /> <br />Wa~rSuppty: <br />Priva~Well ( ) Spring ( ) <br />CommunityWcll ( ) Ci~y <br /> <br />Phon~ No. ~tt/L <br />Phone No. <br /> <br />3. FEES <br /> <br /> ** Fees include DEQ Su~harge ($30.00) <br /> Site Evaluation, Single Family Dwelling, first lot ......................................................................................................... $320.00 <br /> Site Evaluation, Single Family Dwelling, ea addl lot ...................................................................................................... 235.00 <br /> Site Evaluation, Commercial, first 1000 gallons ............................................................................................................. 320.00 <br /> Site Evaluation, Commercial 1000 - 5000 gallons .................................................................................... 320.00 + $90/500/gal <br /> Site Evaluation, Rm'al Area Variance .............................................................................................................................. 320.00 <br /> Construction Permit or Commercial Major Repair, first 1000 gallons: <br /> Standard System ................................................................................................................................. 382.00 <br /> Aerobic System .................................................................................................................................. 218.00 <br /> Capping Fill System ........................................................................................................................... 593.00 <br /> Cesspool ............................................................................................................................................. 382.00 <br /> Disposal Trench in Saprolite .............................................................................................................. 382.00 <br /> Evapolxanspiration-Absoxpfion System ............................................................................................. 218.00 <br /> Gray Water Disposal Sump ............................................................................................................... 190.00 <br /> Pressure Distribution System ............................................................................................................. 553.00 <br /> Redundant System ............................................................................................................................. 382.00 <br /> Sand Filter System ............................................................................................................................. 703.00 <br /> Seepage Pit ......................................................................................................................................... 312.00 <br /> S~epaga Trench .................................................................................................................................. 382.00 <br /> Steep Slope .............................................................................................................. : .......................... 382.00 <br /> Tile Dewatering System ..................................................................................................................... 550.00 <br /> Construction Permit or Commercial Major Repair, over 1000 gallons: <br /> Construction Permit Fee <br /> Commemial Plan Review <br /> 600 gallons - 1000 gallons ............................................................................................................... 133.00 <br /> 1000 gallons - 2500 gallons ............................................................................................................... 133,00 <br /> Commercial Minor Repair ........................................................................................................................................... 173.00 <br /> Single Family Dwelling, Minor Repair (tank only)....~ ............................................. i........i ........................................ 130.00 <br /> Single Family Dwelling, Major Repair (dralnfiald) ........................................................................................................ 210.00 <br /> Residential or Commercial: <br /> Alterations .......................................................................................................................................... 378.00 <br /> Permit Renewal, Field Visit ............................................................................................................... 227.00 <br /> Permit Renewal, No Field Visit ......................................................................................................... 115.00 <br /> Authorization, Field Visit .................................................................................................................. 247.00 <br /> Authorization, No Field Visit ............................................................................................................ 117.00 <br /> Existing System Evaluation ............................................................................................................... 247.00 <br /> Annual Evaluation/Alt creative System .............................................................................................. 247.00 <br /> Annual Evaluation Temporary/Hardship Mobile Home .................................................................... 183.00 <br /> Annual Evaluation, Large System ..................................................................................................... 123.00 <br /> Pump or Dosing Siphon ............................................................................................................ ~ .......... 25.00 <br /> Pumper Track Inspection, First Vehicle ............................................................................................................................ 67.00 <br /> Pumper Truck Inspection, Ea Additional Vehicle ............................................................................................................. 40.00 <br /> Septic Reinspoction Fee ..................................................................................................................................................... 25.00 <br /> Septic Inspection for which no fee is specifically indica~d .............................................................................................. 40.00/hr <br /> <br /> $ <br /> <br />+ $100/500 gallons <br /> <br />Receipt: ~5'~7 Total: <br /> <br />+ $25/500 gallons <br /> <br />+ $25/500 gallons <br /> <br />Tat~ Pumped: // Zt~ 7 <br />Pumping Certiticafion Attached: (Y) (bi) <br /> <br />Test Holes Ready: <br /> <br /> <br />