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1~ "CITY U E ONLY MARION COUNTY BUILDING INSPECTION <br /> ..~17. Y U~ ~,~ONL~ COMMUNITY DEVELOPMENT CENTER <br /> Recei~,ed By: . 285 Church St. NE Room 132 <br /> <br />Zoning Validation: _~.. I 8:~am-4:~pm Phone 588-5147 <br /> . ' ~ 24 hr. I~pecfion Line 373-~27 <br /> ~: ~' ~--~ '~ I FnX5oO7~o <br />....... W- <br /> S~E EVaLUATiON A~/OR SEPTIC PERMit APPLICATION <br /> . <br />1. LOCATION OF ~STALLATION ~/ ~/~ <br /> <br /> ~ity ~.~ Use of Stmc~m <br />Su~ivision Lot Block No. Employes <br /> <br />Section Township Range~ Zone Map Wa~r Supply: <br /> ~vate Well ( ) Spring <br />~t Wid~ ~t ~p~ Acres l~cg. ~t Comer ~mmunity Well (~ Cit~ <br /> <br />2. CONTRACTOR INFORMATION <br /> <br /> ** Fees include DEQ Surcharge ($30.~0) <br /> Site Evaluation, Single Family Dwelling, first lot ......................................................................................................... $320.00 <br /> Sile Evaluation, Single Family Dwelling, ea addl lot ...................................................................................................... 235.00 <br /> Site Evaluation, Commercial, first 1000 gallons ............................................................................................................. 320.00 <br /> Site Evaluation, Commercial 1000-5000gallons .................................................................................... 320.00+$901500/gal + $100/500 gallons <br /> Site Evaluation, Rural Area Variance .............................................................................................................................. 320.00 <br /> Construction Permit or Commercial Major Repair, first 1000 gallons: <br /> Standard System ................................................................................................................................. 382.00 <br /> Aerobic System .................................................................................................................................. 218.00 <br /> Capping Fill System ........................................................................................................................... 593.00 <br /> Cesspool ............................................................................................................................................. 382.00 <br /> Disposal Trench in Saprolite .............................................................................................................. 382.00 <br /> Evapotranspiration-Absorption System ............................................................................................. 218.00 <br /> Gray Water Disposal Sump ............................................................................................................... 190.00 <br /> Pressure Distribution System ............................................................................................................. 550.00 <br /> Redundant System ............................................................................................................................. 382.00 <br /> Sand Filter System ............................................................................................................................. 703.00 <br /> Seepage Pit ......................................................................................................................................... 312.00 <br /> Seepage Trench .................................................................................................................................. 382.00 <br /> Steep Slope ....................................................................................................................................... 382.00 <br /> Tile Dewatering System ..................................................................................................................... 550.00 <br /> Construction Permit or Commercial Major Repair, over 1000 gallons: <br /> Construction Permit Fee + $25/500 gallons <br /> Cormneralal Plan Review <br /> 600 gallons - 1000 gallons ............................ : ................................................................................. 133.00 <br /> [000 gallons - 2500 gallons .............................................................................................................. 133.00 + $25/500 gallons <br /> Corrm~ercial Minor Repair ............................................................................................................................................... 173.00 <br /> Single Family Dwelling, Minor Repair (tank only) ......................................................................................................... 130.00 <br /> Single Family Dwelling, Major Repair (drainfield) ........................................................................................................ 210.00 <br /> Residential or Commercial: <br /> Alterations .......................................................................................................................................... 378.00 <br /> Permit Renewal, Field Visit ............................................................................................................... 227.00 <br /> Permit Renewal, No Field Visit ......................................................................................................... 115.00 <br /> Authorization, 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 Temporatygclardship Mobile Home .................................................................... 183.00 <br /> Annual Evaluation, Large System .................................................................................................... 123.00 <br /> Pump or Dosing Siphon ....................................................................................................................... 25.00 <br /> Pumper Track Inspection, First Vehicle ............................................................................................................................ 67.00 <br /> Septic Inspection for which no fee is specifically indicated ................................................................................... Q~Rec~~ ~-~:~' :0.00/hr,,~[~ ~ ~,zf0 <br />Name of Applicant (Please Print): Test Holes Ready: '~ <br /> <br /> <br />