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MARION COUNTY BUILDING
<br /> 226 High Street NE
<br /> S~m, OR 97301
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<br /> C~e-A-~one 588-79~
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<br />SiTE EVALUATION AND/OR SE~IC ~
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<br />Subdivision
<br />Mobile florae Park
<br />Set~ion ,,, 'l'ownslfip
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<br />2. Contractor Infor~tton
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<br />Aufll. Ag*nt~eo M~ling AddresS: ' ~ Phone NO.
<br />Con~act~ BOs3~*.* N~e & Num~ M~]i~
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<br /> Commor¢ial (DSP-Daily gowage Flow)
<br /> gila Evaluationt first 1000 gal; DS,F $ 200;00 ;20.00
<br /> Sim l~valuafioa, ~. addL 500 gal. D~F 60.00 20.00/m
<br /> Constmcqion & Repair Permits
<br /> Sta~dardSy~t~nli~n 1000gal. D~, "' 200.00 10,00
<br /> Standm-d System mo~ than 1000 gal. DSF,: ,
<br /> $200.00. $15/eaeh addl. 300 gal. DSF 10.130
<br /> Capping Fib 130.00 10.00
<br /> Dilpo~;d TJeehehe$ in S~prolite .... 200.00 10,00
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<br /> Ho!fling Tank .....,, 200.00 i0100
<br />P~nfsuv3 Distribution ...... '~g0.00 10.00
<br />Sand Filter ~5.00 10.00
<br />Se~a[$o '£rench 200.~0 10.00
<br />'ij!~ Dewat~fing System" ,, ,, 280.00 ' i0.00
<br />Plan Review,
<br />600 gal, D§,F, 100i gal, DSF 80.00 .00
<br />, ,(eXeeEt SAND FfLTERS)
<br />For eaiJh additional $00 ga]. I~$F 20.00 .00
<br />Existing System Evaluation Report ....... 120.00 ' l
<br />Autho~!?~,tion Notice (Field Vis&). ,!20.00 10.00
<br />Authorlzation N?tiee (No Field Via]t) .... 70.00 10.00
<br />Annual EYa!ua6on of Large S yst~rn 75.00 10.00
<br />Poraper Truck Inspection, F!?t truck $0.00 ,00
<br />P!~rapcr Truck In~ecfipn.,,ea. addl: track 35,00 .00
<br />Olhc~r .....
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<br />(M~rk Lf Applicable to this Application) ) 'lZsl Hole* a~e Dug
<br /> ) I wdl call when Tes ~ole.~ Dug
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<br />) 1 all/performing work on a property I own or o¢¢~lpy
<br />) Iarn a registered builder ~ ( ) ~1o autltol~d m~cnMfiv6
<br /> of a registered tiuilder,
<br />) 'D}e work will ~ ~fform~l by a DEQ D~nsed l~qt alIer
<br />) Ofl~cr
<br />) 1 agree [o jn.~mH decor(ting to die $ub~itt~ plans and
<br /> speclflcMion~, dm ]a~ of the State of Oregon and the
<br /> ordinanc0s of Marion County,
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<br />Residential Single Family 200.00 $20,00
<br />Si!e EvaluafionI fnt~[ lot ~' $
<br />Site, Evaiuafion, ea. addl, 10t 165,~0 20.00
<br />Construction permit
<br />Sta~.d~mi System ............ ,,, 200.~ 10.(K~
<br />Capping Fill 330,(XJ lO.00 ......
<br />Disposal Trench i~ Saproh{~ 200.00 I0,00
<br />Gray W~!er Disposal Sump ,, 95.(g3 10.01~
<br />Holdlng Tank 200,(X) I0.00
<br />PreSSt~ Di~ibutlon 280,0~ f0,00
<br />Redondant 200.(~ 10.00
<br />Salt Filter 355,~ 10.00
<br />S99page Trench
<br />Steep Slope 200.{X] 10,00
<br /> 280,~ ~0.00
<br />Til* L%wat~fing , ....
<br />Alteration 200.0~ 10.0~
<br />'k,p~. Maj,X..!dr~n,ld) ...... ¢~70C 10.(V0 -
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<br />Repair, Minor (tank) 60,0~
<br />Conslrucllp~ Pemfit Renewal (F!¢ld Visit) 126,0q ' 10.00
<br />Cmistruetion Permlt Renewal (No Fi*Id Visi$)..
<br />,Rcinspeaion Fen 25.0(I .00 ......
<br />Aufl~or~zation Notice IField Visit) .,120-~ 10,0~
<br />Autho~iza~?nN~tic~J(NoHel~.,vi~iO 70,00 10,00
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<br />A,n.nual Evaluation/Altem~iv¢ System --- 12(1.(E .0~ ........ , .....
<br />Annual EvaluatjpnIfcmp. or
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<br />MC 15-74 REV 1/92
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