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F_DI~ CIT~ USE ONLY <br />Received By: __ <br /> <br />Zoning Validation: <br /> <br />[Date: <br /> <br />MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVELOPMENT CENTER <br /> 3150 Lancaster Dr. NE - Suite C <br /> Salem, Orego~ 97305 <br /> <br /> ~4 hr. lnspe~ion Line 373-4~27 <br /> FAX $~-7948 / <br /> <br /> SITE EVALUATION AND/OR SEPTIC PERMIT APPLICATION <br />1. LOCATION OF INSTALL] VION <br /> <br />2. CONTRACTOR INFORMATION <br /> <br /> Auth. ^g~ <br /> <br />3. FEES <br /> <br /> Sil~ Evaluation, Single Family Dwelling, first lot ......................................................................................................... $320,00 <br /> <br /> Sit~ Evaluation, Commercial, first 1000 gallons ............................................................................................................. 320.00 <br /> Sit~ Evaluation, Commercial 1000-5000gallons .................................................................................... 320.00+ $90/500/gal +$100/500galhins <br /> <br /> Seepage Trench .................................................................................................................................. 382.00 <br /> <br /> 600 gallons - 1000 gMIons ............................................................................................................... 133,00 <br />Single Family Dwelling, Minor Repair (~ank only) ......................................................................................................... 130.00 <br /> <br /> Permit R~newal, Field Visit ..................................... iiiiiiiiiiiiiiiiiiii'.iiiiiiiiiiii',iiiiiiiiiiii .... 227'~(~ ~'J') · <br /> Permit Renewal, No Field Visit ................................................................................................ iiil.....~i~_~d <br /> Authon~za~on' Field Visit ................................................................................................... ~ ~ <br /> Existing System Evaluation ............................................................................................................... 247.00 <br /> Pump or Dosing Siphon ....................................................................................................................... 25.00 <br /> <br />Septic Ralnspection Fee ...................................................................................................... 25 00 <br />S ~,tic Inspection for which e~ fee is specifically indicated .................................................. iii ................ iii ~ 00far <br /> <br />Pumping Certification Attache~) <br /> <br /> <br />