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· COMMUNITY DEVELOPMENT CENTER I i~.% ~ '~lli :~ ' ,~ 285 ChurchSt. NE - Room 132 Jll]~ ~'~ · ' Salem, Oregon97301 SEP 2 5 1998 Validation: $:0O.ra-4:,0,m l'ho.e ,Sa-S,,? q ~:>~_~ Date: 24 hr. Inspection Line 588-7904MARION COUNTY ~ax ss.-?.4~ BUILDING INSPECTION SITE EVALUATION AND/OR SEPTIC PERMIT APPLICATION 1. LOCATION OF INSTALLATION ~A L, ~ ~ 7 ~'t~ ~'~ 2. CONTRACTOR INFORMATION Propemy Owner Mailing Address Phone No. 3. FEES DEQ Surcharge ($30.00) Site Evaluation, Single Family Dwelling, first lot .............. Site Evaluation, Single Family Dwelling, ca addl lot ......... I ......235.00 Sim Evaluation, Commercial, first 1000 ............... 320.00 Site Evaluation, Commercial 1000 - 5000 gallons ...................... 320.00 + $90/500/gal Site Evaluation, Rural Area Variance., . .............. 320.00 Constraction Permit or Commercial Major Repair, first 1000 gallons: Standard System ............................. ~.,..382.00 Aerobic System ................................. Capping Fill System ................................................ 593.00 Cesspool ............ ...................... 382.00 Disposal Trench in Saprolite .............................................................................................................. 382.00 Evapotcanspiration-Absorption System ............................................................................................. 218.00 Gray Water Disposal Sump ............................................................................................................... 190.00 Pressure Distribution System ............................................................................................................. 553.00 Redundant System ............................................................................................................................. 382.00 Sand Filter System ............................................................................................................................. 703.00 Seepage Pit ......................................................................................................................................... 312.00 Seepage Trench .................................................................................................................................. 382.00 Steep Slope ......................................................................................................................................... 382.00 Tile Dewat~ring System ..................................................................................................................... 550.00 Construction permit or Commercial Major Repair, over 1000 gallons: Construction Permit Fee Commercial Plan Review 600 gallons - 1000 gallons ............................................................................................................... 133.00 1000 gallons - 2500 gallons ............................................................................................................... 133.00 Single Family Dwelling, Minor Repair (tank only) ......................................................................................................... 130.00 Single Family Dwelling, Major Repok (dralnfiald) ........................................................................................................ 21 Residential or Connnercial: Alterations .......................................................................................................................................... 378.00 Permit Renewal, Field Visit ............................................................................................................... 227.00 permit Renewal, No Field Visit ..................................................................................................... :... 115.00 Autho~z~tion' Field Visit .................................................................................................................. 247.00 Authorization, No Field Visit ............................................................................................................ 117.00 Existing System Evaluation ............................................................................................................... 247.00 Annual Evainafion/Altemative System .............................................................................................. 247.00 Annual Evaluation Temporary/Hardship Mobile Home .................................................................... 183.00 Annual Evaluation' Larga System ..................................................................................................... 123.00 pump or Dosing Siphon ....................................................................................................................... 25.00 Pumper Truck lmpection' First Vehicle ............................................................................................................................ 67.00 Pumper Truck Inspection, Ea Additional Vehicle ............................................................................................................. 40.00 Septic Reiaspeedon Fee .......................................... ~ .......................................................................................................... 25.00 Septic Inspection for which no fee is specifically indicated .............................................................................................. 40.00/hr Name of Applicam (Pie Siguatum o f Applicant: / + $100/500 gallons + $25/500 gallons + $25~500 gallons