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~FOR CITYUSE ONLY ] MARION COUNTY BUILDING INSPECTI~/~ COMMUNITY DEVELOPMENT CIaNTER ~ccelved By; ~<~ ('-- ~1 285 Church St. Zgning V'alidatio. n Date: "'g/,&l{~'-- a:004m-4:SOpmPhonegga-g147 24 hr. Inspection Lille g88-7904 SITE EVALUATION AND/OR SEPTIC PERMIT 1. LOCATION OF INSTALLATION 2. CONTRACTOR INFORMATION I, Contractor Business Nanm & Number 3. FEES Mailing Address Phon~ No. Mail~gg Addr~ Ph'~n¢ No. ** Fees inelud~ DEQ Sumhatge $ Site Evaluation Single gem ly Dwe ng firs ot ............................... $325.00 Site E~valuation, Single Family Dwelling, ea adgl hit ...................................................................................................... 240.00 Site Evaluation. Commemial, first 1000 gallons ............................................................................................................. 325.00 Site EvMuation, Commercial 1000 - 5000 gMIons .......................................................................................................... 325.00 +$100/500gMlons Site Evaluation~ Rural Ar~a Variance ................................................................ , ...................... 325.00 Constraetion Permit or Commercial Major Repair. first 1000 gallons: Stamiarg System ................................................................................................................................. 387.00 Aerobic System .................................................................................................................................. 2,23.00 Capping Fill System ........................................................................................................................... 598.00 Cesspool ............................................. , ............................................................... ;387.00 Disposal Tr*n¢g in SalXOlit¢ ............................................. ;.: .............. ; ....................... .... .................... 387.00 Evapotranspiration-Absoq>tion System ............................ i ................................................................ 223.00 Gray Water DisposM Sump ..... .............................. ................ ,, 195 00 Holding Tank (Commera a on y) .... . Pres~u~ Distribution System ............................................ ;.i .............................................................. 555.00 Redundant System ............................................................................................................................. 387.00 Sang Filter System ............................................................................................................................. 708.00 Scepag~ Pit ..... . ........................... ' 317 aa Seepage Trench ' .................... :'""'i ............................................... ~'7'~ p $ ope ......................................................................................................................................... 387,00 'Ill, Dewaterlng System ..................................................................................................................... 555.00 Construction Permit or CommemiaI Major Repair, ov*r 1000 gallons; Construction Permit Fee + $25/500 gallons Comm~rMal Plan Review , 600 gM10ns - 1000 gallons .............................................. ~..i ............................................................. ~33.00 . 1000 gMhim - $000 galhina ............................................... ~ ....................... 2 .................................... 3.00 * $25/500 gallons Commercial Minor Repak ................................... . ..................................................................................... 178.00 Single Pamily Dwelling, Minor Repair (tank on y) ..................................... : ............................................................. 135.00 Single Fmnily Dwelling Majoe Repa r (dra nile d) ......................... 2~500 ResidentiM or Colm'n~reiM; Alterations .................................................................................................................................... 383.00 Permit Renewal. Field Visit ..................................... .......... : ................ 12 .................... ii ..................... 11232.00 P~rmit Rcn6wal. No Field Visit ......................................................................................................... 120.00 Authorization, Fielti Visit ............................................... , .......................................... 252,00 Au boriza on, No Fie d V $ t ............................................... ............................................................. 121},00 Existing $Tstem Evaluation ............................................... , ............................................................... 252,00 Armual ]~valuation~Alt ernative System .............................................................................................. 252,00 Annum Evaluation Temporary/Hardship Mobile Home , .......................... 188,00 AnnuM Evaluation, Large System ..... , ........ 128 00 Pump or Dosing Siphon ....................................................................................................................... 25,00 Pumper Track Inspection, First Vehicle .......................................................................................................................... 102.00 Pumper Truck Inspection, 6a Additional Vehicle ............................... '. ............ ................................................................. 40.00 Septic Reiaspeetion Fee ........................ , .......................................................................................... 25.00 . , Septic Inspection for whi,¢h no fee is specifieMly indicated ................................................................................... 40 0~hr C'~,,~ / Pumpbg Ccrtificatlon Atlached'. (Y) (N)