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i~OR.OFFICE USE ONLY MARION COUNTY B~D~G ~SPEC~ON ~ ~ <br /> Zoning vaiatio~ ~ ~,,~o~o~ ~ 0 ~ ]~<~ /~/'' <br /> Dat~: P_~ V~ ~ ~ g:00 m~ - 4:30 pm Phone 588-5147 <br /> ,, Code. A-Phone 588-79~ ~.-- <br /> ~ ~-~4~ ~iL'"?~O~'u,~vlN~ COu~,~,~ , r · <br />1. Location of Ins~ ~ <br /> <br />SubdiviSion ~ffOff~ ~ ~t ']~ ~ Block <br /> <br />tractor SnformatlO~ ~-. ,~ ,,'% ~ <br /> <br />¢omlrRorcial (DSF -Daily Sewage Flow') S <br />Site Evaluafion~ tint I000 8al, DSF 245.00 ..... 20.00 <br />~ite Evaluatig~I ea. addl, 500 ga~. DSF 75.00 20.00lin <br />Const~Jon & ~pait Pe~its <br />~nda~ S~?tem less than 100p ~a[, DSF 245,00 -~0,00 <br />Smndyd S~$~m mo~ ~ha~ 1000 ~1. <br />$245.00 +$I$ ~ach ~dL 500 ~I. DSF 10,00 <br />C~pip~ F~ 4i5.oo lO,OO <br />Disposal T~nch~ ~a Sa~li~ 245.90 10.00 <br />Omy W?er Waat~ Dispoml lump 120,00 10~00 <br />Holdin8 Tank 245~00 , 10.00 <br />PmssU~ Distfib~tiofi' 350,00 <br />Redundant $y~m 24~,00 1~,00 <br />$~nd Filt*r 445,00 10.00 <br />, ,Seepage T~enc~ 24~,00 10.~ <br />Steep SI9~e 245,00 10.00 <br />Til~ Dewa~fing System 350.00 10,00 <br />Plan R,view <br />>600 ~al. DSP~<1001 ga},,~SF ..100,00 ' .00, <br /> <br /> ,,(For ~h ~dRional, 500 gal D~F 25.00 ,oo <br /> <br />Coaslmctlon P~it Ron*wal (dield,yisits) 150,0~,, 10,00 <br />Con,matron Pe~iI Renewal (No Field Visit} 85.~ 10,00 <br />~iating System Evaluation Repoa 150,00 10.0~, <br />Authod~don Notice (Fiel~ Vis~t) 150.00 10.00 <br />A~thofi~tion Notiee,,~o Field Visit) ...... 85.00, <br />Annual Evalaatio~ ofAltematiw Sys~m 150.0~ 10.00 <br />Annual Evaluation of~ System 90.00 ,10.00 <br />~mp~r Track Inspection. ~a, ~dl~ track , }5,00 .00 <br />Other <br /> <br />(Mack if Applicable to this Appl}eatloa) ) Test Holes am Dug <br /> ) I w/Il call when Test Holes Dus <br /> <br /> i am perfornMng work on a property I own or occupy <br />) I am a registered builder 0r ( ) the authorized lepreaentative <br />The work will be performed by a DEQ Licensed Installer <br />Olher <br /> <br />R%identj, al Singie Faintl~ <br />Site Evaluationt first lot ,~,~5.00 20.00 <br />Site l~valuationt ea. add]. lot ~ 205,00 20.00 <br />S~nd~ System ~ 5,00 ~ <br />Sand,hl~r ~5,00 IO,QO <br />~*pag~ T~ch 24}.00 10.00 <br />R~pair~ ~or (dminfi¢ld),, ~15,00 10,00 <br />~ast~ct~on P~it R~no~l (~ield Visit) 150.00 10,00 <br />~onstmction P¢~it,~encwal ~o Field Vi~} 85.00 1900 <br />Autho~tioa Not{~ (Fi~id V~slt) 150.0~, 10.00 <br />Annual Ev~uati~emp, et HaMship M~ 90,00 30 <br /> <br /> logy o <br /> Total <br /> <br />of the S~ of O~gon and th~ offijnancea <br /> <br />NAME O_F APP~gI~ple~e/e(~tt~O~.,/ <br /> <br />SIGNATURE OF APPLICANT: DATE: <br /> <br />MC 15-81 REV 2/93 <br /> <br /> <br />