SESPNEW - 1350744 - Laserfiche WebLink

Home Browse Search

]~ FOI~.CITY USE ONLY MARION COUNTY BUILDING INSPECTION · COMMUNITY DEVELOPMENT CENTER ]R~el¢~d By: ~ 285 Ch~ch St. NE - Room 132Salem, Oregon 97301 ~.~ JZoning yali~tion: ~ 8:00am~:30pm Phone 58~5147 SITE EV~UATION AND/OR SEPTIC PE~IT APPLICATI~ 1. LOCATION OF INSTALLATION Section I I Township ! C51 .~ Lot Width q.,,~¢} Lot Depth ~>~.~' 2. CONTRACTOR INFORMATION Range Zone &~,,~. ~ ] Map/c} Irreg. Lot V~__~ 5 Comer PhoneNo. ~ ~5% 3 ~ Cross Street Use of Structure No. Employees Existing No. Proposed No. Bedrooms Bedrooms Water Supply: Private Well () Spring (), Community Well ( ) City (,4' Property Owner ]~'/~k~l~l,x. ~'~[[(5 Mailing Address ~.l~), ~ (-/~65 PhoneNo. <~t-~3~?z'~ Auth. Agent/Leasee .~:~,tn~ ~_~ Mailing Address ~ ~ ti4- Phone No. Contraetor BusinessName&Nurnber ~-Q.L~t'~,~ ~~ ~ Mailing Address Phone No. 3. FEES ** Fees include DEQ Sumharge ($30.00) Site Evaluation, Single Family Dwelling, first lot ......................................................................................................... $320.00 Site Evaluation, Single Family Dwelling, ea addl lot ...................................................................................................... 235.00 Site Evaluation, Commercial, first 1000 gallons ............................................................................................................. 320.00 Site Evaluation, Commercial 1000 - 5000 gallons .................................................................................... 320.00 + $90/500/gal Site Evaluation, Rural Area Variance .............................................................................................................................. 320.00 Construction Permit or Commercial Major Repair, first 1000 gallons: Standard System ................................................................................................................................. 382.00 Aerobic System .................................................................................................................................. 218.00 Capping Fill System ........................................................................................................................... 593.00 Cesspool ............................................................................................................................................. 382.00 Disposal Trench in Saprolite .............................................................................................................. 382.00 Evapotranspiration-Absorption System ............................................................................................. 218.00 Gray Water Disposal Sump ............................................................................................................... 190.00 Pressure Distribution System ............................................................................................................. 553.00 Redundant System ............................................................................................................................. 382.00 Sand Filter System ............................................................................................................................. 703.00 Seepage Pit ......................................................................................................................................... 312.00 Seepage Trench .................................................................................................................................. 382.00 Steep Slope ......................................................................................................................................... 382.00 Tile Dewatering System ..................................................................................................................... 550.00 Construction Permit or Commercial Major Repair, over 1000 gallons: Construction Permit Fee Commercial Plan Review 600 gallons - 1000 gallons ............................................................................................................... 133.00 1000 gallons - 2500 gallons ............................................................................................................... 133.00 Commercial Minor Repair ............................................................................................................................................... 173.00 Single Family Dwelling, Minor Repair (tank only) ......................................................................................................... 130.00 Single Family Dwelling, Major Repair (drainfield) ........................................................................................................ 210.00 Residential or Commercial: Alterations .......................................................................................................................................... 378.00 Permit Renewal, Field Visit ............................................................................................................... 227.00 Permit Renewal, No Field Visit ......................................................................................................... 115.00 Authorization, Field Visit .................................................................................................................. 247.00 Authorization, No Field Visit ............................................................................................................ 117.00 Existing System Evaluation ............................................................................................................... 247.00 Annual Evaluation/Alternative System .............................................................................................. 247.00 Annual Evaluation Temporary/Hardship Mobile Home .................................................................... 183.00 Annual Evaluation, Large System ..................................................................................................... 123.00 Pump or Dosing Siphon ....................................................................................................................... 25.00 Pumper Truck Inspection, First Vehicle ............................................................................................................................ 67.00 Pumper Truck Inspection, Ea Additional Vehicle ................................................................................. 40.00 Septic Reinspeetion Fee ..................................................................................................................................................... 25.00 Septic Inspection for which no fee is specifically indicated .............................................................................................. 40.00/hr Name of Applicant (Please Print): MC 15-SI Rev 8/95 Date: Receipt:_ o + $100/500 gallons + $25/500 gallons + $25/500 gallons Test Holes Ready: 3/1x1% Dire Tank Pumped: Date Pumping Certification Attached: (Y) (N)