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FOR CITY USE ONLY <br />~.eci~i'.;ed By: -.~ <br />Zoning V~lidation: <br /> <br />MARION COUNTY BUILDING <br /> COM MUN ITY DEVELOPMENT CENTER <br /> 285 Ch~h St. NE - ~m 132 <br /> Salem, O~gon 97301 <br /> <br /> ~ hr. Ins~flon Lin~ 5~-79~ F~ <br /> <br /> SITE EVALUATION AND/OR SEPTIC PERMIT API~A~I~N <br />1. LOCATION OF ~ST~LA~ON <br /> <br />2. CONTRACTOR INFORMATION <br /> \\',%.- <br /> <br />3. FEES <br /> <br />Mailing Addtess Phone No <br />Mailing Address Phone No <br /> Pho..,o' .f q-? <br /> <br />*'* Fees include DEQ Sumha~g~ ($30.00) <br />Site Evaluation, Single Family Dwelling, first lot S3~0.00 <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 Evaluatiom Rural Area Vatianc~ 320 00 <br />Consmiction peamt or Commercial Major Repan-, first 1000 gallons: <br /> Standard System 382.00 <br /> Aerobic System 21800 <br /> Capping Fill System 593.00 <br /> Cesspool 382.00 <br /> Disposal Trench in Saptolite 382.00 <br /> Evapotranspiration-Absorption System 218 00 <br /> Gray Wa~er Disposal Sump 190 00 <br /> Pressur~ Disa'ibution System 553 00 <br /> Redundanl System 382 00 <br /> Sand FiRe[ System 70300 <br /> Seq~aga Pit 312.00 <br /> Seepage Trench 382.00 <br /> Steep Slope 382.00 <br /> Tile Dcwateting System 550.00 <br />Constraction Permit or Commercial Major Repan'. over 1000 gallons: <br /> Construction Permit Fee <br />Commercial Plan Review <br /> 600 gallons - 1000 gallons 133.00 <br /> 1000 gallons - 2500 gallons ....... :'" .................... : 2. 133.00 <br />Commercial Minor Repair 173.00 <br />Single Family Dwelling, Minor Repair (~ank only) 13000 <br />Single Family Dwelling, Major Repmr (drainfield) 21000 <br />Residential or Conunercial: <br /> Alterations 378.00 <br /> Pennit Renewal. Field V- ~ <br /> mt 27.00 <br /> Permit Renewal. No Field Visit 115.00 <br /> Authorizatiom Field Visit 247.00 <br /> Authorization. No Field Visit 117.00 <br /> Existing System Evaluation 247.00 <br /> Annual Evaluation/Alternative System 247.00 <br /> Annual Evaluation Temporm3,/Hardship Mobile Home 183.00 <br /> Annual Evaluation, Large System 123.00 <br /> Pump or Dosing Siphon 25.00 <br />Pumper Truck Inspection. Firs~ Vehicle 67.00 <br />Pumper Track Inspection. Ea Additional Vehicle 4000 <br />Septic Re nspec ion Fee 25.00 <br />Septic Inspection for which no fee is specifically indicated ~4,0 00/]g <br /> <br />$100/500 gallons <br /> <br />+ $25/500 gallons <br />+ $25/500 gallons <br /> <br />Test Holes Ready: <br /> <br />Pumping Certification Att~ched~l~) 0q) <br /> <br /> <br />