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Zouing Validation ~-/
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<br />MARION COLrN~rY BUII,DING INSPECTIOI~ ~
<br /> JUL
<br /> ~e~ OR 97301
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<br /> 8~0 ~-4:]0 pmPho.~ 58S-~147 MARION COUNTY
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<br /> ' 5I r ~: EVALUATION AND/OR SEPTIC PE10/IIT APPLICATION
<br />1, Location 0f Installation
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<br />2: CoOtraetor lnfor~atioq ,,
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<br />Auth, Agent/L~a~e Malllng Address; ; Phone No.
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<br /> Commercial (DSF. DailySewaee Fiow~ $
<br /> ..... Site EvaluationI ea. addL 500 Fral. DSF 75~00 20.00/m
<br /> Constnletion & Repair Perrnit~
<br /> .... Stand*rd System I~ss than 1000 ~al_ DSF 24~,00 tO,O0
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<br /> .... Standard System m9~ than 1090 ~al. DSF:
<br /> $245,00 + $1 $ each addL 500 gal, DSF
<br /> CappingFill 415100 10.00
<br /> Di~ o~i Trenches in$ elite 24S.00 10.00
<br /> Gray Water Waste Disposal Sump 120.00 .... .10,00
<br /> l%ldlng Tank " 245.00 IO.O0
<br /> Pmasu~e Distribution 350.00 }10.00
<br />Redundant System 245.00 , JO,O0
<br />,.,~aud F}lter 44~,00 10.00
<br />Seepage Trench 245.00 I 0,.00
<br />Sleep Slope 245.00 I0.00
<br />>600 ~a{. DSF,<!00{ gui, DSF ~00,00 -00
<br />~, (For ~a~h additional fi00 ~al, DSF 25.00 .00
<br />Al~emtio n.~* 245.00 i0:90
<br /> Repair. MinoS . 7~.00 10D0
<br /> Construction Penuit l:~n~wal {Field Visit) 1 fiO.O0 10-00
<br /> .... ¢o~structio ~,~grmit Renewal ~ro 1"i¢ I~1Visi~] S~.O0 I0.00
<br /> F~xisting Sys~m Evaluation Report 150.00 10.00
<br /> Authorization Notice (Field Visit) I fO.00 I0.00,
<br /> Authu~izatioa lqotigu 0qo Field Via{i) $S.00
<br /> Annual Evaluation of Allorualive System 150,00
<br /> ,,,Annua Evalu,atlon of Large System 90.00
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<br />(Mark if Applkablg to this Application) ) 'rest Holes are Du8
<br /> ) I w}ll call when Test Holes I~g
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<br />) I am a t~giateuud builder or ( ) the authorizer representative
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<br /> Residential Single Family
<br /> Site l~valualion, fix~t lot 245.00 20.00
<br /> site Evalu~tlo~: ea. addl. lot ';'05,00 20.00
<br /> Const. ruetion penrdt .,
<br /> S~nda~ Sy~m 245,00 10-00 ....
<br /> Ca,ping Fill .... 41 ~,00 I
<br /> Di~o~[ ~ueh in $aom}ite 245.00I
<br />O~y W~r B}~ ~mp [20,00 10.00
<br />Holding Tank., 245,00 10,00
<br />~s~ Dian~ufiou $50,00 10.00
<br />_~ndaat 245.~ I0.~
<br />~d Fil~r ~,00 I ~.00
<br />~epage T~uch 245,00 I0,00
<br />Steep S{op~ 24~.00
<br />Tile ~w~ehu$ 350.00 .... 10.00
<br />~{~}ou 24~:00 10.00
<br />Repair, ~{or (d~iaficld) {15.00 10,00,
<br />~p~r, ~aor (~k) 75.00
<br />Cou~me~oa Ya~I Renewal (Fi~{d Visi0 15~;00
<br />Construction P~t ~ngwal ~o Plt}d Vis/t) 85,00 1~,00
<br />Reinspecfi~u Fee 25,00 .00
<br />[~'Authomfioa,,~otiee ~o Field Visit) 85.00 10.00
<br />~istin8 Sg~m ~v~uation 150,00 10.00
<br />Annual Ev~u~o~e~, o~ Ha~ship ~ 90.00 '~
<br />~[ A~a V~om Site Ev~u~on 245,00 20.00
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<br />MC 15-SI REV 2/93
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