Laserfiche WebLink
[ .os crrY vsEb-- g- <br />~e~ed By: _~ <br />IZonln. g Validation: <br /> Date: __ <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY D£VELOPMENT CENTER <br /> 3150 Lancaster Dr. NE - Suite C <br /> Salem, Oregon 97305 <br /> 8:~Oam.4:30pm Phone $88-SM7 <br /> 24 hr. Inspection Line 373-4427 <br /> FAX 588-7948 <br /> <br /> SITE EVALUATION AND/OR SEPTIC PERMIT APPLICATION <br />1. LOCATION OF INSTALLATION <br /> <br />2. CONTRACTOR INFORMATION <br />Auth. Ageat/l.eas~ [ ' ' g Phone No. <br /> <br />Site Evaluation, Single Family Dwelling, ea addl lo~ ...................................................................................................... <br />Site Evalualion, Comm~clal, first 1000 gallons ...................................................................................................... <br /> <br /> Cesspool ............................................................................................................................................. 382.00 <br /> EvapoU-anspiration-Absotption System ............................................................................................. 218.00 <br /> <br /> --[ t~ ................................................................................................................ 550 <br />Co~tme0.on l~anit or Comm~miM Major Repair, over 1000 gallons: <br /> <br /> 1000 ~llons - 2.500 gallons ............................................................................................................... 133.00 <br /> <br />Single Family Dwell!rig,..Migor ~ (.t~r. only) ......................................................................................................... 21~0.~ <br />Single Family Dwelling, Major Rq~m' (dminfield) ........................................................................................................ u. <br /> <br /> S*pd¢ Rein~p~tion Fe~ ..................................................................................................................................................... 25.00 <br /> Se4~¢ I~i~cfion for which no f, i~ ~pecifi~ly indica~t .............................................................................................. 40.00thr <br /> <br />+ $100/500 gallons <br /> <br />+ $251500 gallons <br /> <br />+$~15~gallons <br /> <br />Test Holes Ready: <br /> Oate <br /> <br />Tank Puml~d: <br /> <br />Pumping Certification Attached: (Y) (N) <br /> <br /> <br />