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F~,~, ,-~xw,,, USE O~"~ MARION COUNTY BUiLDING INSPECTION <br />'~r'~ ,,~a.a ~. ~o~ ~ ] COMMUNITY D~V~LOPMENT CENTER <br />Received By' ~ [ 2~5 Chu~h St, NB - Room <br />...... ] Satem, O~gon 9730] <br /> <br /> SiTE EVALUATION A~/OR SEPTIC PERMIT &PPLIC~ <br /> <br />$ita Evaluation, Coronle,~ial, fl~t 2{300 gaJlon~ ............................... r ............................................................................. 325.00 <br />$itn ~valuatiou, Commercial I000 - $000 gailon~ .......................................................................................................... 325,00 <br /> <br /> Aerobic System .................................................................................................................................. 223.00 <br /> <br /> Holding Tank (Commercial only) ............... <br /> pressure Diatdbutlon Systeca ............................................................................................................. 353.00 <br /> <br /> Sand F~Iter iysmm ........................................... 2 ............. ; ................................................................... 708,00 <br /> <br /> .- Trarlch .................................................................................................................................. 387,00 <br /> le ......................................................................................................................................... 387,00 <br /> <br />q- $100/5~0 gallons <br /> <br /> gallons; <br /> Constawtiou Permit Fee <br />commercial Plma Review <br /> 600 gallons ~ 1000 gallons ............................ ................................................................................... 183,00 <br /> <br /> Commercial Minor Repair .............................................................................................................................................. 1Ti,00 <br /> Single Faruily Dwelling Minor R~palr (taalq only): ............................................................................................... 135.00 <br /> Single Family Dwelling, M~jot Repair (dnfinfie]d) ........................................................................................................ 213.00 <br /> Residential or Commercial: <br /> AIteratlotla ..................................................... c .................................................................................... 383.00 <br /> <br /> Permlt Renewal, No Field ¥1alt ......................................................................................................... 120.00 ~ - _k~ls¢~ <br /> Authorization, Field Vilcit .................................................................................................................. 252,00 <br /> Attthorizatio~, No Field Visit ............................................................................................................ 122,00 <br /> Exiating Syatara Evaluation ............................................................................................................... 252.00 <br /> Annual Bvalnation/Alteruafiw. System .............................................................................................. 252,00 <br /> Annual Evaluation T~mgoraryflqatxtshig Mobil¢ Home .................................................................... lgg.00 <br /> Annual Evaluation, Largo System .............. ; ...................................................................................... 128 <br /> Pump or Dosing Siphon ....................................................... ; ............................................................... 25.00 <br /> Pumper Truck Inap~etiou, First V~hiule .......................................................................................................................... 102,00 <br /> Pumper Truck lnspeutlon, Ea Additional Vehicle ............................................................................................................. 40.00 <br /> <br /> Septic Inspection for which no fee is sp~ifically indiaatgd ..................................... <br /> <br />Name of Appllcant (Please Pri~:_ ~ <br />Signature of Applicant: 3~~__Oale: <br /> <br />Test l-loles Ready: <br /> <br />Tank Pumped; <br /> <br />Pumoin~ Cet'tification Attached: (¥~ (N~ <br /> <br /> <br />