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Zoning Valid~i. on: }~, ? _ [ MARION COUNTY BUILDING INSPECTION Salem. O~gon 97301 8:00am-a:30pm ~mne 588-5147 ~ SITE EVALUATION AND/OR SEPTIC PERMIT APPLIC~'~ LOCATION OF INSTALLATION $uh~llvlsion LO~ Block NO, Employes 2. CONTRACTOR INFORMATION ~ntraemrBu~lneSSN~m=&Number ~¢~ff0 3. FEES M~lingA~di~ ,O ~ Z~ ' PhoneNo. j · o/g ............ ** F~ inet.~d~ DEQ Surcharge $ Site Evaluation. Single Faraily DweIling flint lot ....................... 2. ' $325,00 Site Evaluation, Co~reiM. firzt 1000 gallons ............................................... ............ ' ...................... 325'00 Si~ Evalaagoa. Rural Area Variance .............................................................................................................................. 325,00 Cons~ction Permit or Co~¢~ial Major Rcp~r, f~st I000 gallons: Sta.~a~ Sys~m ................................................................................................................................. 387,00 ~ Ggq~ ~ A~bi= Syate~ ..................................................... : .............. , .................... , ......... 223.00 Capping Fill Sys~m .............. : , ;: ~..]~ ......... 21 ........................................................... 598.00 Disposal ~n¢h in Sa~lite .......................................................... , ...................... 387.00 Gray Wa~r Disposal Su~p, .............................................. '~ .............................................................. 195.00 ~olding Ta~ (Comm~ia on y) ...................................................................................................... 387.00 Sand Fil~r 8ys~m ........................... , .................................... 708.00 Seepage ~t ......................................................................................................................................... 317.~ S~pa~ Tmeh .................................................................................................................................. 387.~ St~p SlOpe ................................................................. ........................................................................ 387.00 Tile Dowa~fing System ..................................................................................................................... 555.00 Const~o~on Pe~Jt or Co~=rc~al Major Repair, over 1~0 gallons: Condition Pe~{t ~ + $~/5~ gallons Com~¢~ial Plan Review 600 gallons - I000 sallons ........................... , ............................ ~ .............................. I33.00 IQ00 sallons - 5000 g~ on~ .......................................................................................... 133.00 * $~/5~ gallons ¢Olme~ial Minor Repair ............ . .................................................................................. 178,~ S ~ e Faro ly Dwelling. M nor RepOt (~k on y) .......... .............................................................................. ,..... .......... 135,00 Single F~Iy Dwelling Major Repair (~a nile d) .......................... 215 00 Resld=nti~ ut Comme~inh Pomit Ren¢wal, No ~ield Visit ......................................................................................................... 120.00 Au~odzation, Field V~sit ............................ , ......................................... 2~2.00 Au ho~za on, NoF~dVst ............................................................................................................ 122.00 Existing Sysmm Evaluation .............................. , ....................................................... 252 ~ Ann~a Bra ua onlA temafive Systm ............................................................ .......... ; ................... 252 00 Annual Evaluation Tempo~W~hip Mobile Homo ..................................... 188,00 Annu~ Evaluation, Larg~ Sys~m ..................................................................................................... 128.00 Pump or DoMng Siphon ...................................................... 2 ............................................................... 25.00 Pumper Tmek Inspeefi0n, First V~icle .......................... , .................. 102 ~ Pumphlg Ce~ification Attached: (Y)