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FOR CITY USE.ONLY MARION COUNTY BUILDING <br />tl~2J'~.~ COMMUN~Y DE~LOPM~ CE~R <br />Received By~-'~ ~ 285 ~mh St. ~ - R~m 132 <br /> <br /> - - · O~ S~em, Oregon 97301 <br />~omng ~,datlon: ~ 8:00m-4 3~m Phone 58~5147 <br />Date' ~3 ~ ~hr ~pect onL~e5~-79~ <br /> <br /> sIt EVArU XION n/OR SE IC PEmIX <br /> <br />Lot Bilk No. Employees <br /> ~va~ W,11 () Spring <br /> <br />2. CONTRACTOR INFORMATION <br />Property Owner Marling Address Phone No. <br /> Ma]llng Address . Phone No. <br /> <br />3, FEES <br /> <br /> Site Evaluation, Commercial, first 1000 gallons ............................................................................................................. 325.00 <br /> Site Evaluation, Commercial 1000 - 5000 gallons .......................................................................................................... 325.00 + $100/500 gallons <br /> Site Evaluation, Rural Area Variance .............................................................................................................................. 325.00 <br /> <br /> Aerobic System .................................................................................................................................. 223.00 <br /> Capping Fill System ........................................................................................................................... 598,00 <br /> Cesspool ............................................................................................................................................. 387.00 <br /> <br /> Ev apoa anspitafion-Ab sorption System ............................................................................................. 223.00 <br /> Gray Water Disposal Sump ............................................................................................................... 195.00 <br /> Holding Tank (Commercial only) ...................................................................................................... 387.00 <br /> Pressure Distribution Sys em ............................ 555 O0 <br /> <br /> Seepage Pit ......................................................................................................................................... 317.00 <br /> Seepage Trench .................................................................................................................................. 387.00 <br /> Steep Slope ......................................................................................................................................... 387.00 <br /> <br /> Construction Permit Fee + $25/500 gallons <br /> Commercial Plan Review <br /> 600 gallons - 1000 gallons ............................................................................................................... 133.00 <br /> 1000 gallons - 5000 gallons ............................................................................................................... 133.00 + $25/500 gallons <br /> <br /> Single Family Dwelling, Minor Repair (tank only) ......................................................................................................... 135.00 <br /> Single Family Dwelling, Major Repair (dminfield) ........................................................................................................ 215.00 <br /> Residential or Commercial: <br /> Alterations .......................................................................................................................................... 383.00 ---~ ~, O 0 <br /> Permit Renewal No Field Visit ........................................................... 120.~) <br /> Authorization, Field Visit .................................................................................................................. 252.00 <br /> <br /> Existing System Evaluation ............................................................................................................... 252.00 <br /> <br /> Annual Evaluation Temporary, Hardship Mobile Home .................... 188.00 <br /> Annual Evaluation, Large System ..................................................................................................... 128.00 <br /> Pmnp or Dosing Siphon ....................................................................................................................... 25.00 <br /> <br /> Septic Inspection for which no fee is specifically indicated .............................................................................................. 40.00/hr <br /> <br />N~ae of Applicant (Please Ptln~ /~_.~,,/cr~-,~l~,,,/~ <br />Signature of App,lcant: ]~, ~/~.~ ~) ' V,.~ C~ Tank Pumped: <br /> <br /> <br />