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FOR CITY USE ONLY MARION COUNTY BUILDING INSPECTION <br /> COMMUNITY DEVgLOPMEIW? CENTER <br />Received By: ~-/'~C'''~ 285 Church St, NE - Room 132 <br /> - - Salem, Or¢gon ~7301 <br />Zoni'ngValid~t.',, :5~n ~ 8:00am4:30pmPhonegSg-$147 <br /> <br /> FAX $88.7948 P~C~ <br /> SITE EVALUATION AND/OR SEPTIC PERMIT A N <br />L LOCATION OF INSTALLATION <br /> <br /> ~ ~j~fing No. P~pa~ N .... <br />~tWldih ~0--_. LotDepth ~ Acres__, I~g,I.Ot Comer ~0 CommunltyWelt () City <br /> <br />2. CONTRACTOR INFORMATION <br /> <br /> . FEES <br /> <br />Site Evaluation. Single Family Dwelling, ea addl lot ...................................................................................................... 240.00 <br />Sire Evaluation, Commercial, first 1000 gallons ............................................................................................................. 325.00 <br />Site Evaluation, Commercial 1000 - 5000 gallons .......................................................................................................... 325,00 + $100/500 gallons <br />$}te Evaluation, Rural Area Valance .............................................................................................................................. 325.00 <br /> <br /> Cesspool ......................................................................................................................... 3117 00 <br /> ' ............. 387 00 <br /> <br /> Gray Water Disposal Sump ............................................................................................................... 195.00 <br /> Holding Tank (Commercial only) ...................................................................................................... 387.00 <br /> Pressure Distribution System ............................................................................................................. 555.00 <br /> <br /> Sand Filter System ............................................................................................................................. 70}1,00 <br /> Seepage Pit ......................................................................................................................................... 317.00 <br /> Seepage 'French .................................................................................................................................. 387.00 <br /> Steep Slope ......................................................................................................................................... 387,00 <br /> <br /> Construction Permit Fee + $25/500 gallons <br />Coramercial Plan Review <br />600 gallons - 1000 gallons ............................................................................................................... 133.00 <br />1000 gallons - 5000 gallons .............................................. 7': ............................................................. 133.00 <br /> <br /> Single Family Dwelling, Minor Repair (tank only) ......................................................................................................... 135.00 <br /> Single Family Dwelling, Major Repair (dralnfield) ........................................................................................................ 2 15,00 <br /> <br /> Alterations .......................................................................................................................................... 383.00 <br /> Permit Renewal. Field Visit ............................................................................................................... 232.(}0 <br /> <br /> Existing System Evaluation ............................................................................................................... 232.00 <br /> <br /> Pump or Dosing Siphon ....................................................................................................................... 25,00 <br /> Pumper Track Inspection, First Vehicle .......................................................................................................................... 102.00 <br /> <br /> Septic Reinspection Fee ..................................................................................................................................................... 25.00 ~.~ <br /> <br />Dare: /9~ao. ~O.~ / ~'~.~ Tank Pumped: <br /> <br /> <br />